Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 8114 | MT |
NPI | 1013399500 |
---|---|
Provider Name | Sheri Moran |
First Address | Billings, MT 59101-5446 |
Second Address | Billings, MT 59101-0913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2015 |
Last Update Date | 22/06/2015 |