Healthcare Provider Details

I. General information

NPI: 1033409727
Provider Name (Legal Business Name): RHONDA SCHROCK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 04/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 13TH AVE S
GREAT FALLS MT
59405-4406
US

IV. Provider business mailing address

914 13TH AVE S
GREAT FALLS MT
59405-4406
US

V. Phone/Fax

Practice location:
  • Phone: 406-761-3767
  • Fax: 406-761-3038
Mailing address:
  • Phone: 406-761-3767
  • Fax: 406-761-3038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA53930
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: