Provider Demographics
NPI:1083132534
Name:DREYER, KARIE ANN (LMT)
Entity Type:Individual
Prefix:
First Name:KARIE
Middle Name:ANN
Last Name:DREYER
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 1:4750 JORDAN SPUR RD
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-9328
Mailing Address - Country:US
Mailing Address - Phone:406-580-0980
Mailing Address - Fax:
Practice Address - Street 1:4750 JORDAN SPUR RD
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-9328
Practice Address - Country:US
Practice Address - Phone:406-580-0980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-05
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-8192225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist