Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 295 | MT |
NPI | 1003172842 |
---|---|
Provider Name | Tina R Dion |
First Address | Cut Bank, MT 59427-2914 |
Second Address | Cut Bank, MT 59427-2914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2012 |
Last Update Date | 05/04/2012 |