Trevor Daniel Boe, LMT

Individual provider Active NPI Massage Therapist · Missoula, MT

NPI 1104675784 · NPPES record last updated May 15, 2024

Key facts

NPI
1104675784
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
LMT-LMT-LIC-24866 (MT)
Practice address
2409 Dearborn Ave Ste E
Missoula, MT 59801-7748
Phone
(406) 543-7860
NPI assigned
May 15, 2024
Sex
Male
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

LicenseStateTypeSpecialty
LMT-LMT-LIC-24866MTMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X LMT-LMT-LIC-24866 MT Yes

Addresses

Primary practice location

2409 Dearborn Ave Ste E
Missoula, MT 59801-7748

Mailing address

PO Box 35
Seeley Lake, MT 59868-0035
Phone (406) 303-0220

Other providers in Missoula, MT

All providers in Missoula, MT · Massage Therapist in Montana

Sources for this page

Verify at the official NPI Registry.