Provider Demographics
NPI:1073224010
Name:TAKE FLIGHT MASSAGE LLC
Entity Type:Organization
Organization Name:TAKE FLIGHT MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:JOINER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT/NMT
Authorized Official - Phone:406-499-1348
Mailing Address - Street 1:215 MARCUS ST STE 216
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-3220
Mailing Address - Country:US
Mailing Address - Phone:406-499-1348
Mailing Address - Fax:406-510-2658
Practice Address - Street 1:215 MARCUS ST STE 216
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-3220
Practice Address - Country:US
Practice Address - Phone:406-499-1348
Practice Address - Fax:406-510-2658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty