Provider Demographics
NPI:1891098646
Name:SHAFER-RAU INC
Entity Type:Organization
Organization Name:SHAFER-RAU INC
Other - Org Name:SHAFER-RAU PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:N
Authorized Official - Last Name:SHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-443-2751
Mailing Address - Street 1:2625 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4912
Mailing Address - Country:US
Mailing Address - Phone:406-443-2751
Mailing Address - Fax:406-443-2751
Practice Address - Street 1:2625 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4912
Practice Address - Country:US
Practice Address - Phone:406-443-2751
Practice Address - Fax:406-443-2751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-17
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT97225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000005840Medicare UPIN