Healthcare Provider Details

I. General information

NPI: 1992001515
Provider Name (Legal Business Name): HAVE FAITH IN MASSAGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2011
Last Update Date: 01/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 HOSPITAL WAY
WHITEFISH MT
59937-7858
US

IV. Provider business mailing address

2006 HOSPITAL WAY
WHITEFISH MT
59937-7858
US

V. Phone/Fax

Practice location:
  • Phone: 406-212-9756
  • Fax:
Mailing address:
  • Phone: 406-212-9756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FAITH ANN CORPRON
Title or Position: MASSAGE THERAPY
Credential:
Phone: 406-212-9756