Basic Information
| Provider Information | |||||||||
| NPI: | 1013135300 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORNETET | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | SUE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1821 LAURA CIR | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591061715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4066522414 | ||||||||
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| Practice Location | |||||||||
| Address1: | 820 3RD AVE | ||||||||
| Address2: | |||||||||
| City: | LAUREL | ||||||||
| State: | MT | ||||||||
| PostalCode: | 590442023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4066288251 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1702 | MT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.