Provider Demographics
NPI:1194370270
Name:FISCHER, REBECCA CLAIRE (DPT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:CLAIRE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:CLAIRE
Other - Last Name:BERLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1940 HARVE AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-8332
Mailing Address - Country:US
Mailing Address - Phone:406-542-0808
Mailing Address - Fax:406-542-0909
Practice Address - Street 1:1940 HARVE AVE STE 2
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8332
Practice Address - Country:US
Practice Address - Phone:406-542-0808
Practice Address - Fax:406-542-0909
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPTP-PT-LIC-17187225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist