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General NPI Number Information
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NPI Number | 1619009719
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Entity Type | Individual
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Provider Name | AMY GLORIA HAYNES ND LAC
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Gender | Female
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 521 S 2ND ST W
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City | MISSOULA
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State | MT
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Zip | 59801
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Country | US
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Telephone | 406-721-2147
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Fax | 406-728-0978
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Provider Business Mailing Address
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Address Line | 521 S 2ND ST W
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City | MISSOULA
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State | MT
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Zip | 59801
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Country | US
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Telephone | 406-721-2147
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Fax | 406-728-0978
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 32
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 39
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License Number State | MT
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