Provider Demographics
NPI:1164977906
Name:LANDRY, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LANDRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4524
Mailing Address - Country:US
Mailing Address - Phone:406-869-1066
Mailing Address - Fax:406-869-1099
Practice Address - Street 1:2711 HOWARD AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102
Practice Address - Country:US
Practice Address - Phone:406-850-1616
Practice Address - Fax:406-850-1616
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-22
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC8108225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist