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Individual

JACLYN GEBHARDT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
220 WOODEN SHOE LN STE C, MANHATTAN, MT 59741-8379
(406) 284-4262
(406) 284-4203
Mailing address
1823 W COLLEGE ST STE 100, BOZEMAN, MT 59715-4915
(406) 556-0562
(406) 556-0965

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
9824567-2401
UT
225100000X
Physical Therapist
Primary
PTP-PT-LIC-11210
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTP-PT-LIC-11210
STATE LICENSE
MT
Enumeration date
06/22/2016
Last updated
12/02/2025
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