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General NPI Number Information
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NPI Number | 1114390549
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Entity Type | Organization
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Legal Business Name | MYOFASCIAL RELEASE OF MONTANA
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Dates
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Enumeration Date | 11/06/2015
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Last Update Date | 11/09/2015
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Provider Practice Location Address
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Address Line | 2309 CRIMSON LN
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City | BILLINGS
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State | MT
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Zip | 59106-4717
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Country | US
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Telephone | 406-794-9139
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Fax |
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Provider Business Mailing Address
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Address Line | 2309 CRIMSON LN
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City | BILLINGS
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State | MT
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Zip | 59106-4717
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | JFB EXPERT MYOFASCIAL RELEASE PRACT
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Name | PAULA PASEK
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Credential | MOTR/CHT
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Telephone | 406-794-9139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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