Provider Demographics
NPI:1336536614
Name:7 WELLNESS & MASSAGE CENTER
Entity Type:Organization
Organization Name:7 WELLNESS & MASSAGE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARYAH
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:406-696-3908
Mailing Address - Street 1:1925 GRAND AVE
Mailing Address - Street 2:SUITE 134
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2764
Mailing Address - Country:US
Mailing Address - Phone:406-696-3908
Mailing Address - Fax:406-252-3171
Practice Address - Street 1:1925 GRAND AVE
Practice Address - Street 2:SUITE 134
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2764
Practice Address - Country:US
Practice Address - Phone:406-696-3908
Practice Address - Fax:406-252-3171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5952225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty