Provider Demographics
NPI:1669838702
Name:MCCRUMB, KIRSTEN J (DPT)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:J
Last Name:MCCRUMB
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:KIRSTEN
Other - Middle Name:J
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:203 SMELTER AVE NE STE B
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-1924
Mailing Address - Country:US
Mailing Address - Phone:406-727-2826
Mailing Address - Fax:406-727-3522
Practice Address - Street 1:203 SMELTER AVE NE STE B
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-1924
Practice Address - Country:US
Practice Address - Phone:406-727-2826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist