Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 2093 | MT |
NPI | 1013269034 |
---|---|
Provider Name | Mr. Aaron Gams |
First Address | Helena, MT 59624-1011 |
Second Address | Helena, MT 59601-5938 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2012 |
Last Update Date | 15/10/2012 |