Provider Demographics
NPI:1841202314
Name:ARMITAGE, JENNIFER L (PT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:L
Last Name:ARMITAGE
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 1:1276 N 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3289
Mailing Address - Country:US
Mailing Address - Phone:406-587-2755
Mailing Address - Fax:406-587-2783
Practice Address - Street 1:1276 N 15TH AVE
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3289
Practice Address - Country:US
Practice Address - Phone:406-587-2755
Practice Address - Fax:406-587-2783
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5806225100000X
MT2258225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6404043OtherMEDICA
MNHP41510OtherHEALTH PARTNERS