Healthcare Provider Details

I. General information

NPI: 1245988757
Provider Name (Legal Business Name): SHAYLAH RAE TOKAR LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 CENTRAL AVE STE D
BILLINGS MT
59102-8624
US

IV. Provider business mailing address

66 W ANTELOPE TRL APT 1
BILLINGS MT
59105-2900
US

V. Phone/Fax

Practice location:
  • Phone: 406-259-4908
  • Fax: 406-252-0040
Mailing address:
  • Phone: 406-670-5501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberLMT-LMT-LIC-13817
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: