1821384116 NPI number — MS. JUNE JEANNIE O'CONNOR MASSAGE THERAPIST

Table of content: MS. JUNE JEANNIE O'CONNOR MASSAGE THERAPIST (NPI 1821384116)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821384116 NPI number — MS. JUNE JEANNIE O'CONNOR MASSAGE THERAPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'CONNOR
Provider First Name:
JUNE
Provider Middle Name:
JEANNIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MASSAGE THERAPIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821384116
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/24/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
517 DEWEY AVE.
Provider Second Line Business Mailing Address:
L'ANGEVIN GARDEN SPA
Provider Business Mailing Address City Name:
EUREKA 59917
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59917
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-297-7322
Provider Business Mailing Address Fax Number:
406-297-7747

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
517 DEWEY AVE.
Provider Second Line Business Practice Location Address:
L'ANGEVIN GARDEN SPA
Provider Business Practice Location Address City Name:
EUREKA
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59917-0301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-297-7322
Provider Business Practice Location Address Fax Number:
406-297-7747
Provider Enumeration Date:
06/24/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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