Provider Demographics
NPI:1013135300
Name:CORNETET, LINDA SUE (PT)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:SUE
Last Name:CORNETET
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1821 LAURA CIR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-1715
Mailing Address - Country:US
Mailing Address - Phone:406-652-2414
Mailing Address - Fax:
Practice Address - Street 1:820 3RD AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MT
Practice Address - Zip Code:59044-2023
Practice Address - Country:US
Practice Address - Phone:406-628-8251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1702225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist