Healthcare Provider Details

I. General information

NPI: 1124960174
Provider Name (Legal Business Name): TRIAS REVOLUTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 KADZIE AVE
MILES CITY MT
59301-2259
US

IV. Provider business mailing address

1503 KADZIE AVE
MILES CITY MT
59301-2259
US

V. Phone/Fax

Practice location:
  • Phone: 406-981-1536
  • Fax:
Mailing address:
  • Phone: 406-981-1536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: AMORMALUS FORCE
Title or Position: CEO/COACH
Credential:
Phone: 406-981-1536