Provider Demographics
NPI:1639695828
Name:OZSSAGE LTD
Entity Type:Organization
Organization Name:OZSSAGE LTD
Other - Org Name:OZSSAGE LTD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RAGER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT BCMT
Authorized Official - Phone:406-995-7575
Mailing Address - Street 1:PO BOX 160072
Mailing Address - Street 2:
Mailing Address - City:BIG SKY
Mailing Address - State:MT
Mailing Address - Zip Code:59716-0072
Mailing Address - Country:US
Mailing Address - Phone:406-995-7575
Mailing Address - Fax:
Practice Address - Street 1:32 MARKET PLACE
Practice Address - Street 2:OZSSAGE LTD
Practice Address - City:BIG SKY
Practice Address - State:MT
Practice Address - Zip Code:59716
Practice Address - Country:US
Practice Address - Phone:406-995-7575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-18
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-59225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty