MEDICARE: MS. EMMA LYNN UPTON 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-29701	MT

General Provider Information

NPI Number	:	1538014774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EMMA LYNN UPTON LMT

Provider Business Mailing Address
First Line	:	178 2ND AVE E.N.
Second Line	:	SUITE B
City	:	KALISPELL
State	:	MT
Zip	:	59901-4123
Country	:	US
Telephone Number	:	406-261-4641
Fax Number	:

Provider Business Practice Location Address
First Line	:	178 2ND AVE E.N.
Second Line	:	SUITE B
City	:	KALISPELL
State	:	MT
Zip	:	59901-4123
Country	:	US
Telephone Number	:	406-261-4641
Fax Number	:

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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