Provider Demographics
NPI:1710327804
Name:HENDERSON, JOSHUA J (PT,DPT)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:J
Last Name:HENDERSON
Suffix:
Gender:M
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1347 S WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-2936
Mailing Address - Country:US
Mailing Address - Phone:406-207-3672
Mailing Address - Fax:
Practice Address - Street 1:1520 24TH ST W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2666
Practice Address - Country:US
Practice Address - Phone:307-235-3910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT15229225100000X
WY1486225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist