Healthcare Provider Details

I. General information

NPI: 1598683831
Provider Name (Legal Business Name): KERI KINGLAND LMT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 NORTHWEST BYP
GREAT FALLS MT
59404-4141
US

IV. Provider business mailing address

294 WASHINGTON BLVD
GREAT FALLS MT
59404-6211
US

V. Phone/Fax

Practice location:
  • Phone: 406-788-4601
  • Fax:
Mailing address:
  • Phone: 406-788-4601
  • Fax: 406-788-4601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: KERI KINGLAND
Title or Position: OWNER, LMT
Credential:
Phone: 406-788-4601