Provider Demographics
NPI:1427113687
Name:ALLIES, JENNIFER DAWN (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:DAWN
Last Name:ALLIES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:DAWN
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:PO BOX 2114
Mailing Address - Street 2:
Mailing Address - City:COLSTRIP
Mailing Address - State:MT
Mailing Address - Zip Code:59323-2114
Mailing Address - Country:US
Mailing Address - Phone:406-748-3092
Mailing Address - Fax:
Practice Address - Street 1:2420 PINE BUTTE DR
Practice Address - Street 2:
Practice Address - City:COLSTRIP
Practice Address - State:MT
Practice Address - Zip Code:59323
Practice Address - Country:US
Practice Address - Phone:406-748-3092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1646PT225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist