Provider Demographics
NPI:1134465776
Name:BUDKE, AMY LYNN (CMT, LAC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:LYNN
Last Name:BUDKE
Suffix:
Gender:F
Credentials:CMT, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 N EWING ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3606
Mailing Address - Country:US
Mailing Address - Phone:406-447-6346
Mailing Address - Fax:
Practice Address - Street 1:414 N BENTON AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5040
Practice Address - Country:US
Practice Address - Phone:406-447-6346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-01
Last Update Date:2013-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT243171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist