Provider Demographics
NPI:1609991447
Name:PLISHKA, CHARLES MARTIN (DPT)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:MARTIN
Last Name:PLISHKA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 N 27TH ST STE E
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0100
Mailing Address - Country:US
Mailing Address - Phone:225-252-9332
Mailing Address - Fax:
Practice Address - Street 1:1101 N 27TH ST STE E
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0100
Practice Address - Country:US
Practice Address - Phone:406-245-6893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04358225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA7430288040OtherOHP PROVIDER NUMBER
LA51-0602902OtherEIN