NPI Code Details Logo

NPI 1376917567

NPI 1376917567 : SHARLYSSA ELINE DUNCAN : STEVENSVILLE, MT

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1376917567
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    SHARLYSSA ELINE DUNCAN
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    11/25/2015
-----------------------------------------------------
    Last Update Date     |    11/25/2015
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    212 MAIN STREET 
-----------------------------------------------------
    City                 |    STEVENSVILLE
-----------------------------------------------------
    State                |    MT
-----------------------------------------------------
    Zip                  |    59870
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    406-777-1048
-----------------------------------------------------
    Fax                  |    406-777-1038
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    212 MAIN STREET ACTIVE CARE FAMILY CHIROPRACTIC
-----------------------------------------------------
    City                 |    STEVENSVILLE
-----------------------------------------------------
    State                |    MT
-----------------------------------------------------
    Zip                  |    59870
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    406-777-1048
-----------------------------------------------------
    Fax                  |    406-777-1038
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    225700000X
-----------------------------------------------------
    Taxonomy Name        |    Massage Therapist
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.