Provider Demographics
NPI:1396401279
Name:PEAK HEALTH MASSAGE LLC
Entity Type:Organization
Organization Name:PEAK HEALTH MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:LEBLANC
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:406-871-8609
Mailing Address - Street 1:28 TREASURE LN
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-5116
Mailing Address - Country:US
Mailing Address - Phone:406-871-8609
Mailing Address - Fax:
Practice Address - Street 1:22 2ND AVE W STE 1300
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4480
Practice Address - Country:US
Practice Address - Phone:406-871-8609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty