MEDICARE: TINA UELAND

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	509	MT

General Provider Information

NPI Number	:	1407228976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA UELAND

Provider Business Mailing Address
First Line	:	2481 GALEN RD
Second Line	:
City	:	ANACONDA
State	:	MT
Zip	:	59711-9581
Country	:	US
Telephone Number	:	406-560-1678
Fax Number	:

Provider Business Practice Location Address
First Line	:	124 OAK ST
Second Line	:
City	:	ANACONDA
State	:	MT
Zip	:	59711-2335
Country	:	US
Telephone Number	:	406-560-1678
Fax Number	:

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

Provider Enumeration Date	:	10/23/2015
Last Update Date	:	01/31/2016

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Directions to “ TINA UELAND ” Practice Location

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