Healthcare Provider Details

I. General information

NPI: 1477462414
Provider Name (Legal Business Name): LINCY IDA JOHNSON LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 CARBON ST STE 5 SUITE #5
BILLINGS MT
59102-6414
US

IV. Provider business mailing address

811 N 31ST ST
BILLINGS MT
59101-0953
US

V. Phone/Fax

Practice location:
  • Phone: 406-318-7754
  • Fax:
Mailing address:
  • Phone: 406-697-0582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberLMT-LMT-LIC-33001
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: