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General NPI Number Information
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NPI Number | 1346104148
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Entity Type | Individual
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Provider Name | TATE BOLEY
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Gender | Male
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Dates
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Enumeration Date | 12/15/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 1001 W OAK ST STE 210
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City | BOZEMAN
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State | MT
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Zip | 59715-8757
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Country | US
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Telephone | 406-587-8446
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Fax |
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Provider Business Mailing Address
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Address Line | 1207 E MAIN ST # 150
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City | BOZEMAN
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State | MT
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Zip | 59715-3849
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Country | US
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Telephone | 307-349-0110
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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