Provider Demographics
NPI:1013720838
Name:ORTHOAPOTHECARY MASSAGE
Entity type:Organization
Organization Name:ORTHOAPOTHECARY MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:WALENTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, HHP
Authorized Official - Phone:406-304-0715
Mailing Address - Street 1:PO BOX 564
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MT
Mailing Address - Zip Code:59935-0564
Mailing Address - Country:US
Mailing Address - Phone:406-304-0715
Mailing Address - Fax:
Practice Address - Street 1:609 WEST 8TH STREET
Practice Address - Street 2:UNIT B
Practice Address - City:LIBBY
Practice Address - State:MT
Practice Address - Zip Code:59923
Practice Address - Country:US
Practice Address - Phone:406-304-0715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty