Tracie Lajuan Bollinger, MASSAGE THERAPIST
Individual provider Active NPI Massage Therapist · Mandan, ND
NPI 1033415468 · NPPES record last updated Feb 2, 2011
Key facts
- NPI
- 1033415468
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 644 (ND)
- Practice address
- 509 Burlington St SE
Mandan, ND 58554-4272 - Phone
- (701) 224-1561
- Fax
- (701) 223-2319
- NPI assigned
- Feb 2, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 644 | ND | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 644 | ND | Yes |
Addresses
Primary practice location
509 Burlington St SE
Mandan, ND 58554-4272
Mailing address
509 Burlington St SE
Mandan, ND 58554-4272
Phone (701) 224-1561
Other providers in Mandan, ND
- Chelsea Bittner
- Patricia Blake
- Kim Bloms
- Colleen Boehm
- Michelle Bohn
- Donna Bolme
- Trevor M Bolme
- Laura Boucher
- Judith Bouzid
- Michele Boyer
All providers in Mandan, ND · Massage Therapist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.