Provider Demographics
NPI:1972608040
Name:SITTER, WENDY (PT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:SITTER
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 1:508 3RD AVE E
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860-2411
Mailing Address - Country:US
Mailing Address - Phone:406-261-7742
Mailing Address - Fax:406-883-0760
Practice Address - Street 1:508 3RD AVE E
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-2411
Practice Address - Country:US
Practice Address - Phone:406-261-7742
Practice Address - Fax:406-883-0760
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT15712251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT3400714Medicaid
MT61341OtherBLUE CHIP