Individual
STEPHEN HISEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1700 W KOCH ST, SUITE 12, BOZEMAN, MT 59715-4148
(406) 587-6057
Mailing address
1700 W KOCH ST, SUITE 12, BOZEMAN, MT 59715-4148
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
633PT
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3401139
—
MT
01
—
61058
BLUE CROSS/BLUE SHEILD
MT
Enumeration date
09/29/2006
Last updated
07/09/2007
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