Provider Demographics
NPI:1700362654
Name:QUICK, HEATHER (LMT MMP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:QUICK
Suffix:
Gender:F
Credentials:LMT MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:478 GREEN BELT DRIVE
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-9552
Mailing Address - Country:US
Mailing Address - Phone:406-388-6812
Mailing Address - Fax:
Practice Address - Street 1:3925 W BROADWATER ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6387
Practice Address - Country:US
Practice Address - Phone:406-282-1104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-11897225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist