Provider Demographics
NPI:1225742380
Name:PIERCE, CASSIDY (CSCS, ATS)
Entity Type:Individual
Prefix:
First Name:CASSIDY
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:CSCS, ATS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 BIG FLAT RD
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-9412
Mailing Address - Country:US
Mailing Address - Phone:406-552-7188
Mailing Address - Fax:
Practice Address - Street 1:3060 BIG FLAT RD
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-9412
Practice Address - Country:US
Practice Address - Phone:406-552-7188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty