Provider Demographics
NPI:1033453964
Name:GEORGI, LILIAN (LMT)
Entity Type:Individual
Prefix:
First Name:LILIAN
Middle Name:
Last Name:GEORGI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2981 HIGHWAY 200
Mailing Address - Street 2:P.O. BOX 1283
Mailing Address - City:TROUT CREEK
Mailing Address - State:MT
Mailing Address - Zip Code:59874-1283
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2981 HIGHWAY 200
Practice Address - Street 2:
Practice Address - City:TROUT CREEK
Practice Address - State:MT
Practice Address - Zip Code:59874-1283
Practice Address - Country:US
Practice Address - Phone:406-827-3005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-150225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist