Sandra Kathleen Sample, LMT
Individual provider Active NPI Massage Therapist · Boulder, MT
NPI 1992137681 · NPPES record last updated Jul 1, 2026
Key facts
- NPI
- 1992137681
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- LMT-LMT-LIC-4719 (MT)
- Practice address
- 207 N Main St
Boulder, MT 59632-7761 - Phone
- (406) 560-2164
- NPI assigned
- Aug 5, 2013
- 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 |
|---|---|---|---|
| LMT-LMT-LIC-4719 | MT | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | LMT-LMT-LIC-4719 | MT | Yes |
Addresses
Primary practice location
207 N Main St
Boulder, MT 59632-7761
Mailing address
207 N Main Street
PO Box 793
Boulder, MT 59632
Phone (406) 560-2164
Other providers in Boulder, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2026. 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.