Provider Demographics
NPI:1710044466
Name:AGER, SHELLEE JO (PT)
Entity Type:Individual
Prefix:MS
First Name:SHELLEE
Middle Name:JO
Last Name:AGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 RIMROCK RD
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-0141
Mailing Address - Country:US
Mailing Address - Phone:406-655-5672
Mailing Address - Fax:406-655-5639
Practice Address - Street 1:3940 RIMROCK RD
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-0141
Practice Address - Country:US
Practice Address - Phone:406-655-5672
Practice Address - Fax:406-655-5639
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1442225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist