1770845828 NPI number — DANA MARIE IHRIG MASSAGE THERAPIST

Table of content: DANA MARIE IHRIG MASSAGE THERAPIST (NPI 1770845828)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770845828 NPI number — DANA MARIE IHRIG MASSAGE THERAPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
IHRIG
Provider First Name:
DANA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
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:
ANDERSON
Provider Other First Name:
DANA
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1770845828
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/14/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
203 YELLOWSTONE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BILLINGS
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59101-1817
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-647-0320
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
323 24TH ST W
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BILLINGS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59102-4780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-647-0320
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2012

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: 174H00000X , with the licence number:  487 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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