Provider Demographics
NPI:1770030900
Name:SCHWANKL, VALERIE (LAC)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:SCHWANKL
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59771-0298
Mailing Address - Country:US
Mailing Address - Phone:406-595-4722
Mailing Address - Fax:
Practice Address - Street 1:3985 VALLEY COMMONS DR
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6633
Practice Address - Country:US
Practice Address - Phone:406-595-4722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT50240171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist