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NPI Code Detail

MEDICARE: DIANE COTTRELL LMT

MEDICARE:   DIANE  COTTRELL  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 Therapist242MT

General Provider Information

NPI Number : 1518238237
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE COTTRELL LMT
Provider Business Mailing Address
First Line : 2330 SOUTH DR
Second Line :
City : BUTTE
State : MT
Zip : 59701-6172
Country : US
Telephone Number : 406-239-1180
Fax Number :
Provider Business Practice Location Address
First Line : 5050 HARRISON AVE
Second Line :
City : BUTTE
State : MT
Zip : 59701-7033
Country : US
Telephone Number : 406-494-0772
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2012
Last Update Date : 01/26/2012

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Directions to “ DIANE COTTRELL LMT” Practice Location

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