Provider Demographics
NPI:1508823360
Name:FISCHER, MATTHEW SCOTT (MSPT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:SCOTT
Last Name:FISCHER
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3515
Mailing Address - Country:US
Mailing Address - Phone:406-449-3060
Mailing Address - Fax:406-449-3088
Practice Address - Street 1:1200 N 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
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1618225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0003400986Medicaid
MT0003400986Medicaid
MT000084130Medicare ID - Type UnspecifiedGROUP