Provider Demographics
NPI:1699702076
Name:MCMILLAN, JAMIE L (OTR)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:MCMILLAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 12TH AVE N STE 140W
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-7507
Mailing Address - Country:US
Mailing Address - Phone:406-237-5050
Mailing Address - Fax:406-238-6599
Practice Address - Street 1:2900 12TH AVE N STE 140W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7507
Practice Address - Country:US
Practice Address - Phone:406-237-5050
Practice Address - Fax:406-238-6599
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT955225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000662580OtherBLUE CROSS
MT000050842Medicaid
MT000662580OtherBLUE CROSS