Provider Demographics
NPI:1003370396
Name:TMS MISSOULA LLC
Entity Type:Organization
Organization Name:TMS MISSOULA LLC
Other - Org Name:TMS REVITALIZES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TMS TECHNICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TSCHIDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-493-1344
Mailing Address - Street 1:2809 GREAT NORTHERN LOOP
Mailing Address - Street 2:SUITE 410
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1749
Mailing Address - Country:US
Mailing Address - Phone:406-493-1344
Mailing Address - Fax:406-830-3127
Practice Address - Street 1:2809 GREAT NORTHERN LOOP
Practice Address - Street 2:STE 410
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1749
Practice Address - Country:US
Practice Address - Phone:406-493-1344
Practice Address - Fax:406-830-3127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty