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General NPI Number Information
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NPI Number | 1821384116
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Entity Type | Individual
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Provider Name | JUNE JEANNIE O'CONNOR MASSAGE THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 06/24/2011
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Last Update Date | 06/24/2011
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Provider Practice Location Address
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Address Line | 517 DEWEY AVE. L'ANGEVIN GARDEN SPA
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City | EUREKA
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State | MT
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Zip | 59917-0301
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Country | US
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Telephone | 406-297-7322
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Fax | 406-297-7747
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Provider Business Mailing Address
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Address Line | 517 DEWEY AVE. L'ANGEVIN GARDEN SPA
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City | EUREKA 59917
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State | MT
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Zip | 59917
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Country | US
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Telephone | 406-297-7322
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Fax | 406-297-7747
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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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