Provider Demographics
NPI:1922109628
Name:HEUISER PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:HEUISER PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HEUISER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:406-449-0654
Mailing Address - Street 1:3336 N MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-7816
Mailing Address - Country:US
Mailing Address - Phone:406-449-0654
Mailing Address - Fax:406-449-0516
Practice Address - Street 1:3336 N MONTANA AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-7816
Practice Address - Country:US
Practice Address - Phone:406-449-0654
Practice Address - Fax:406-449-0516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000083868Medicare ID - Type Unspecified