Provider Demographics
NPI:1033413158
Name:DIBRA, BLERIM (DPT, LMT)
Entity Type:Individual
Prefix:DR
First Name:BLERIM
Middle Name:
Last Name:DIBRA
Suffix:
Gender:M
Credentials:DPT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4120 KING AVE W STE 1
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-2927
Mailing Address - Country:US
Mailing Address - Phone:406-707-6082
Mailing Address - Fax:888-383-2362
Practice Address - Street 1:4120 KING AVE W STE 1
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-2927
Practice Address - Country:US
Practice Address - Phone:406-707-6082
Practice Address - Fax:888-383-2362
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT26142225100000X, 2251X0800X, 2251P0200X, 2251E1200X
MTPTP-PT-LIC-25182225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003109600Medicaid