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NPI Code Detail

MEDICARE: JESSICA POWELL RILEY LMT

MEDICARE:   JESSICA  POWELL RILEY  LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist1005MT

General Provider Information

NPI Number : 1821242314
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA POWELL RILEY LMT
Provider Business Mailing Address
First Line : 2933 TERRY AVE
Second Line :
City : BILLINGS
State : MT
Zip : 59102-4528
Country : US
Telephone Number : 406-579-8442
Fax Number :
Provider Business Practice Location Address
First Line : 720 N 30TH ST
Second Line :
City : BILLINGS
State : MT
Zip : 59101-0913
Country : US
Telephone Number : 406-259-5096
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2008
Last Update Date : 12/03/2012

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Directions to “ JESSICA POWELL RILEY LMT” Practice Location

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