Provider Demographics
NPI:1417053091
Name:FISCHER PHYSICAL THERAPY P C
Entity Type:Organization
Organization Name:FISCHER PHYSICAL THERAPY P C
Other - Org Name:FISCHER PHYSICAL THERAPY PC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/BILLING
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-449-3060
Mailing Address - Street 1:1200 NORTH MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601
Mailing Address - Country:US
Mailing Address - Phone:406-449-3060
Mailing Address - Fax:406-449-3088
Practice Address - Street 1:1200 NORTH MONTANA AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601
Practice Address - Country:US
Practice Address - Phone:406-449-3060
Practice Address - Fax:406-449-3088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1618225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000060453OtherBLUE CROSS BLUE SHEILD
MT611493300OtherDEPARTMENT OF LABOR
MT55156OtherNEW WEST HEALTH SERVICES
MT0003400986Medicaid
MT55156OtherNEW WEST HEALTH SERVICES