Provider Demographics
NPI:1992258602
Name:DENISAR-GREEN, BRENT DOUGLAS (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:DOUGLAS
Last Name:DENISAR-GREEN
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:BRENT
Other - Middle Name:DOUGLAS
Other - Last Name:DENISAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1416 LAS PALMAS AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-5533
Mailing Address - Country:US
Mailing Address - Phone:941-387-4099
Mailing Address - Fax:
Practice Address - Street 1:1416 LAS PALMAS AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-5533
Practice Address - Country:US
Practice Address - Phone:941-387-4099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-28
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPTP-PT-LIC-19776225100000X
NCP15799225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist