Provider Demographics
NPI:1922376219
Name:PADILLA, SOPHIA CHRISTINA (LMT, CMT)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:CHRISTINA
Last Name:PADILLA
Suffix:
Gender:F
Credentials:LMT, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 W MAIN ST STE 206
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-3735
Mailing Address - Country:US
Mailing Address - Phone:406-599-8428
Mailing Address - Fax:
Practice Address - Street 1:11 W MAIN ST STE 206
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-3735
Practice Address - Country:US
Practice Address - Phone:406-599-8428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT299225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist