MEDICARE: JESS FROST LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	LMT-LMT-LIC-22329	MT

General Provider Information

NPI Number	:	1104687185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESS FROST LMT

Provider Business Mailing Address
First Line	:	1743 PARK GARDEN RD
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-3650
Country	:	US
Telephone Number	:	406-799-0357
Fax Number	:	406-780-3899

Provider Business Practice Location Address
First Line	:	1743 PARK GARDEN RD
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-3650
Country	:	US
Telephone Number	:	406-799-0357
Fax Number	:	406-780-3899

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2024
Last Update Date	:	01/17/2024

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Directions to “ JESS FROST LMT” Practice Location

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