Provider Demographics
NPI:1134723984
Name:OSTWALT, MADALYN MARIE (LMT)
Entity type:Individual
Prefix:
First Name:MADALYN
Middle Name:MARIE
Last Name:OSTWALT
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 1:720 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0913
Mailing Address - Country:US
Mailing Address - Phone:406-259-5096
Mailing Address - Fax:
Practice Address - Street 1:720 N 30TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0913
Practice Address - Country:US
Practice Address - Phone:406-259-5096
Practice Address - Fax:406-545-0044
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-16230225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist