Provider Demographics
NPI:1760817621
Name:TENNSTEDT, KATARZYNA JR (LMT)
Entity Type:Individual
Prefix:
First Name:KATARZYNA
Middle Name:
Last Name:TENNSTEDT
Suffix:JR
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 1:82 MEADOW BROOK RD
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-9579
Mailing Address - Country:US
Mailing Address - Phone:406-581-0883
Mailing Address - Fax:
Practice Address - Street 1:82 MEADOW BROOK RD
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-9579
Practice Address - Country:US
Practice Address - Phone:406-581-0883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT162225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist