Provider Demographics
NPI:1528578507
Name:STRECKER, MEGGAN JOLENE (LMT)
Entity Type:Individual
Prefix:
First Name:MEGGAN
Middle Name:JOLENE
Last Name:STRECKER
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 1:670 KING PARK DR STE 1
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6257
Mailing Address - Country:US
Mailing Address - Phone:406-655-4940
Mailing Address - Fax:
Practice Address - Street 1:670 KING PARK DR STE 1
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6257
Practice Address - Country:US
Practice Address - Phone:406-655-4940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT13646225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist