Healthcare Provider Details

I. General information

NPI: 1386469120
Provider Name (Legal Business Name): STILL POINT WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 11/18/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 W CENTRAL AVE
FAIRFIELD MT
59436-9341
US

IV. Provider business mailing address

PO BOX 142
SIMMS MT
59477-0142
US

V. Phone/Fax

Practice location:
  • Phone: 406-475-2654
  • Fax:
Mailing address:
  • Phone: 406-475-2654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: HOLLY HAMILTON
Title or Position: OWNER/OPERATOR
Credential: LMT, PTA
Phone: 406-475-2654