Provider Demographics
NPI:1407612864
Name:SANTIAGO, ARNECIA (LMT)
Entity Type:Individual
Prefix:
First Name:ARNECIA
Middle Name:
Last Name:SANTIAGO
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 1:1308 12TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-4607
Mailing Address - Country:US
Mailing Address - Phone:406-453-8885
Mailing Address - Fax:406-453-8887
Practice Address - Street 1:1308 12TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4607
Practice Address - Country:US
Practice Address - Phone:406-453-8885
Practice Address - Fax:406-453-8887
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-26979225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist