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General NPI Number Information
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NPI Number | 1235938184
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Entity Type | Organization
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Legal Business Name | LAVANA CONNECTION LLC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 304 BUCK ST
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City | STEVENSVILLE
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State | MT
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Zip | 59870-2035
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Country | US
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Telephone | 406-531-2509
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Fax |
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Provider Business Mailing Address
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Address Line | 585 DESTINO DR
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City | STEVENSVILLE
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State | MT
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Zip | 59870-6186
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Country | US
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Telephone | 406-531-1858
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | ELIZABETH MARIE LINDQUIST
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Credential |
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Telephone | 406-531-1858
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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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