MEDICARE: RACHEL ANNE OCHOA 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-14578	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LMT-LMT-LIC-14578	OTHER	MT	MONTANA MASSAGE LICENSE

General Provider Information

NPI Number	:	1245880202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL ANNE OCHOA LMT

Provider Business Mailing Address
First Line	:	520 S 2ND ST W UPPR
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-1833
Country	:	US
Telephone Number	:	406-239-9006
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 W ALDER ST STE 20
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-4099
Country	:	US
Telephone Number	:	406-493-1115
Fax Number	:

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

Provider Enumeration Date	:	09/12/2019
Last Update Date	:	09/12/2019

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