Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | LMT-LMT-LIC-6266 | MT |
NPI | 1013323625 |
---|---|
Provider Name | Mr. Thomas James William Robinson |
First Address | Lewistown, MT 59457-5703 |
Second Address | Lewistown, MT 59457-5703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2014 |
Last Update Date | 02/07/2014 |