Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 18460 | MT |
NPI | 1003425182 |
---|---|
Provider Name | Liana J Messer |
First Address | Missoula, MT 59801-4758 |
Second Address | Missoula, MT 59801-4758 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2020 |
Last Update Date | 24/07/2020 |