Provider Demographics
NPI:1316225865
Name:DAY, JENNELL LYN (PT, DPT)
Entity type:Individual
Prefix:
First Name:JENNELL
Middle Name:LYN
Last Name:DAY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JENNELL
Other - Middle Name:LYN
Other - Last Name:HUMPHREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,DPT
Mailing Address - Street 1:600 LOLA ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-8600
Mailing Address - Country:US
Mailing Address - Phone:406-465-3188
Mailing Address - Fax:844-470-2949
Practice Address - Street 1:600 LOLA ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-8600
Practice Address - Country:US
Practice Address - Phone:406-465-3188
Practice Address - Fax:844-470-2949
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2025-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2319225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1212Medicare PIN
IAIB1213Medicare PIN
IAIB1213035Medicare PIN
IAIB1212033Medicare PIN