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General NPI Number Information
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NPI Number | 1396530176
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Entity Type | Organization
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Legal Business Name | MYOFASCIAL RELEASE WORKS
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 04/11/2025
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Provider Practice Location Address
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Address Line | 1816 COLUMBIA FALLS STAGE
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City | COLUMBIA FALLS
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State | MT
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Zip | 59912-9342
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Country | US
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Telephone | 406-403-2626
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Fax |
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Provider Business Mailing Address
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Address Line | 1816 COLUMBIA FALLS STAGE
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City | COLUMBIA FALLS
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State | MT
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Zip | 59912-9342
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Country | US
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Telephone | 406-403-2626
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Fax |
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Authorized Official
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Title or Position | OT
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Name | CHERYL A MOSS
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Credential | OT
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Telephone | 406-403-2626
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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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