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General NPI Number Information
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NPI Number | 1013720838
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Entity Type | Organization
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Legal Business Name | ORTHOAPOTHECARY MASSAGE
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 03/02/2025
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Provider Practice Location Address
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Address Line | 609 WEST 8TH STREET UNIT B
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City | LIBBY
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State | MT
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Zip | 59923
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Country | US
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Telephone | 406-304-0715
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 564
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City | TROY
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State | MT
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Zip | 59935-0564
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Country | US
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Telephone | 406-304-0715
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | STACY WALENTER
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Credential | LMT, HHP
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Telephone | 406-304-0715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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