Jeremiah Bennett, LMT
Individual provider Active NPI Massage Therapist · Darby, MT
NPI 1487424529 · NPPES record last updated Jan 8, 2024
Key facts
- NPI
- 1487424529
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- LMT-LMT-LIC-27033 (MT)
- Practice address
- 106 Gary Ann LN
Darby, MT 59829-8601 - Phone
- (530) 559-1317
- NPI assigned
- Jan 8, 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
| License | State | Type | Specialty |
|---|---|---|---|
| LMT-LMT-LIC-27033 | MT | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | LMT-LMT-LIC-27033 | MT | Yes |
Addresses
Primary practice location
106 Gary Ann LN
Darby, MT 59829-8601
Mailing address
PO Box 254
Darby, MT 59829-0254
Phone (530) 559-1317
Other providers in Darby, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2024. 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.