MEDICARE: LYNN ANN HOLTON 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-28445	MT

General Provider Information

NPI Number	:	1639004096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNN ANN HOLTON LMT

Provider Business Mailing Address
First Line	:	242 STAGE RDG
Second Line	:
City	:	BIGFORK
State	:	MT
Zip	:	59911-3664
Country	:	US
Telephone Number	:	406-282-1879
Fax Number	:

Provider Business Practice Location Address
First Line	:	191 JEWEL BASIN CT STE 3B
Second Line	:
City	:	BIGFORK
State	:	MT
Zip	:	59911-6294
Country	:	US
Telephone Number	:	406-282-1879
Fax Number	:

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

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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