Healthcare Provider Details

I. General information

NPI: 1609991447
Provider Name (Legal Business Name): CHARLES MARTIN PLISHKA D.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 N 27TH ST STE E
BILLINGS MT
59101-0100
US

IV. Provider business mailing address

1101 N 27TH ST STE E
BILLINGS MT
59101-0100
US

V. Phone/Fax

Practice location:
  • Phone: 406-245-6893
  • Fax:
Mailing address:
  • Phone: 225-252-9332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number04358
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: