Katie M Ballweber, LCMT

Individual provider Active NPI Massage Therapist · Missoula, MT

NPI 1376893545 · NPPES record last updated Sep 14, 2012

Key facts

NPI
1376893545
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
LMT-LMT-LIC-2386 (MT)
Practice address
2015 Burlington Ave
Missoula, MT 59801-5425
Phone
(406) 546-7762
NPI assigned
Sep 14, 2012
Sex
Female
Sole proprietor
No

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-2386MTMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X LMT-LMT-LIC-2386 MT Yes

Addresses

Primary practice location

2015 Burlington Ave
Missoula, MT 59801-5425

Mailing address

2015 Burlington Ave
Missoula, MT 59801-5425
Phone (406) 546-7762

Other providers in Missoula, MT

All providers in Missoula, MT · Massage Therapist in Montana

Sources for this page

Verify at the official NPI Registry.