Provider Demographics
NPI:1629609219
Name:MONTANA YOGA THERAPY
Entity Type:Organization
Organization Name:MONTANA YOGA THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:K
Authorized Official - Last Name:ZALESKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-327-0775
Mailing Address - Street 1:2825 STOCKYARD RD STE H3
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1507
Mailing Address - Country:US
Mailing Address - Phone:406-327-0775
Mailing Address - Fax:
Practice Address - Street 1:2825 STOCKYARD RD STE H3
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1507
Practice Address - Country:US
Practice Address - Phone:406-327-0775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-01
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty