Provider Demographics
NPI:1952457962
Name:RAU, DENNIS P (PT)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:P
Last Name:RAU
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT972251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT60210OtherBLUE CROSS BLUE SHIELD
MT0000341198Medicaid