Provider Demographics
NPI:1851581029
Name:MILLINGTON SOWERS, JENNIFER RAE (DPT)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:RAE
Last Name:MILLINGTON SOWERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:MILLINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:526 E OLD SAYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-4983
Mailing Address - Country:US
Mailing Address - Phone:208-447-8244
Mailing Address - Fax:
Practice Address - Street 1:526 E OLD SAYBROOK DR
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-4983
Practice Address - Country:US
Practice Address - Phone:208-447-8244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program