Provider Demographics
NPI:1255577839
Name:HEDOESIT, FAYLENE CATON
Entity type:Individual
Prefix:MS
First Name:FAYLENE
Middle Name:CATON
Last Name:HEDOESIT
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:FAYLENE
Other - Middle Name:ANN
Other - Last Name:HEDOESIT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CMT
Mailing Address - Street 1:PO BOX 163
Mailing Address - Street 2:
Mailing Address - City:SAINT XAVIER
Mailing Address - State:MT
Mailing Address - Zip Code:59075-0163
Mailing Address - Country:US
Mailing Address - Phone:406-861-6346
Mailing Address - Fax:
Practice Address - Street 1:416 N CUSTER
Practice Address - Street 2:
Practice Address - City:HARDIN
Practice Address - State:MT
Practice Address - Zip Code:59034-0416
Practice Address - Country:US
Practice Address - Phone:406-861-6346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-02
Last Update Date:2009-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTT26164172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist