Healthcare Provider Details

I. General information

NPI: 1831466267
Provider Name (Legal Business Name): ELIZABETH T TAYLOR LAYMAN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3027 HWY 83 LAZY PINE MALL
SEELEY LAKE MT
59868
US

IV. Provider business mailing address

155 ALDER LANE
SEELEY LAKE MT
59868-0194
US

V. Phone/Fax

Practice location:
  • Phone: 406-677-7722
  • Fax: 406-677-7723
Mailing address:
  • Phone: 406-210-2887
  • Fax: 406-677-7723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number1328
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: