Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | AHC-NAT-LIC-1964 | MT |
NPI | 1073156600 |
---|---|
Provider Name | Melissa Manda |
First Address | Billings, MT 59101-0745 |
Second Address | Billings, MT 59101-0913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2019 |
Last Update Date | 27/10/2019 |