Steven Mark Wallace, L.M.T

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

13742 Issued in NU

Practice address

1001 W. Oak St. BLDG C. Ste. 210
Bozeman, MT 59715

Phone

(406) 587-8446

Fax

(406) 587-0898

NPI assigned

Feb 2, 2018

Last updated

Feb 2, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517529600000",
    "number": "1649779950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W. OAK ST. BLDG C. STE. 210",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59715",
            "telephone_number": "406-587-8446",
            "fax_number": "406-587-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 W. OAK ST. BLDG C. STE. 210",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59715",
            "telephone_number": "406-587-8446",
            "fax_number": "406-587-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "STEVEN",
        "middle_name": "MARK",
        "credential": "L.M.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-02",
        "last_updated": "2018-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": "13742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Jane Walker, OTR
• Adrianne V Wallace, MFTLC
• Joshua Wallace, LMT
• Maureen V Wallace, MPT
• Richard M. Wallace, M.D.
• Kimberly Glendoria Wallen, CRNA
• John L Waller, MD
• Christopher Ryan Wallis, D.D.S.
• Patricia Walls, NNP, MSN, RNC
• Walmart Inc. (Walmart Pharmacy 10-2084)

• Massage Therapist in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Massage Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.