Provider Demographics
NPI:1760961932
Name:TRUSCOTT, WHITNEY M (LMT)
Entity Type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:M
Last Name:TRUSCOTT
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 1:9050 S 19TH AVE APT C
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-7826
Mailing Address - Country:US
Mailing Address - Phone:906-869-0781
Mailing Address - Fax:
Practice Address - Street 1:2405 W MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-3978
Practice Address - Country:US
Practice Address - Phone:906-869-8071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT13770225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist