Healthcare Provider Details

I. General information

NPI: 1700723616
Provider Name (Legal Business Name): REBEKAH RENE COOK LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 2ND AVE N STE 217
GREAT FALLS MT
59401-3243
US

IV. Provider business mailing address

128 RIVERVIEW D
GREAT FALLS MT
59404-1418
US

V. Phone/Fax

Practice location:
  • Phone: 406-263-2352
  • Fax:
Mailing address:
  • Phone: 406-263-2352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number15702
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: