Provider Demographics
NPI:1619113008
Name:PFISTER PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:PFISTER PHYSICAL THERAPY, PC
Other - Org Name:PHYSIO WHITEFISH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HARMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-407-1231
Mailing Address - Street 1:214 2ND ST E STE 102
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2447
Mailing Address - Country:US
Mailing Address - Phone:406-730-2224
Mailing Address - Fax:406-730-2228
Practice Address - Street 1:214 2ND ST E STE 102
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2447
Practice Address - Country:US
Practice Address - Phone:406-730-2224
Practice Address - Fax:406-730-2228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-06
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
111N00000X, 225100000X
MTPTP-PT-LIC-6099261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty