Provider Demographics
NPI:1689900664
Name:HEISER, RICK D (ODT, OTR/L, CHT,)
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:D
Last Name:HEISER
Suffix:
Gender:M
Credentials:ODT, OTR/L, CHT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 COMMONS LOOP
Mailing Address - Street 2:STE D
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901
Mailing Address - Country:US
Mailing Address - Phone:417-818-0203
Mailing Address - Fax:
Practice Address - Street 1:185 COMMONS LOOP
Practice Address - Street 2:STE D
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901
Practice Address - Country:US
Practice Address - Phone:417-818-0203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-26
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTOTP-OT-LIC-7773225X00000X, 225XH1200X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment