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NPI Code Detail

MEDICARE: MRS. LYNN AILEEN TUCKER LMT

MEDICARE: MRS. LYNN AILEEN TUCKER 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
1225700000XMassage Therapist164MT

General Provider Information

NPI Number : 1356655799
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LYNN AILEEN TUCKER LMT
Provider Business Mailing Address
First Line : 1407 WYOMING AVE
Second Line :
City : BILLINGS
State : MT
Zip : 59102-5301
Country : US
Telephone Number : 406-656-3366
Fax Number :
Provider Business Practice Location Address
First Line : 1407 WYOMING AVE
Second Line :
City : BILLINGS
State : MT
Zip : 59102-5301
Country : US
Telephone Number : 406-656-3333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2010
Last Update Date : 07/27/2010

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