Provider Demographics
NPI:1871065946
Name:HIRTZEL, JASON M (DPT)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:M
Last Name:HIRTZEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 PLOVERVILLE LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728-5440
Mailing Address - Country:US
Mailing Address - Phone:716-536-2881
Mailing Address - Fax:
Practice Address - Street 1:3171 US HIGHWAY 93 N STE C
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1360
Practice Address - Country:US
Practice Address - Phone:406-756-7634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-29
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT.PT.61301374225100000X
HIPT-5554225100000X
NMPT22022225100000X
OR64478225100000X
AZLPT-30077225100000X
UT11079648-2401225100000X
CAPT295364225100000X
MTPTP-PT-LIC-27276225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist