Provider Demographics
NPI:1013016898
Name:LOOSER, LINDA (PT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:LOOSER
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 1:164 S 3RD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2720
Mailing Address - Country:US
Mailing Address - Phone:406-363-2570
Mailing Address - Fax:406-363-7214
Practice Address - Street 1:164 S 3RD ST
Practice Address - Street 2:SUITE B
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2720
Practice Address - Country:US
Practice Address - Phone:406-363-2570
Practice Address - Fax:406-363-7214
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1433225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0349350Medicaid
MT61378OtherBCBS INDIVIDUAL #
MT5607238Medicaid
MT000083001Medicare ID - Type UnspecifiedMEDICARE GROUP UPIN
MT650025360Medicare ID - Type UnspecifiedMEDICARE RAILROAD
MT61378OtherBCBS INDIVIDUAL #
MT000050580Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL #