Provider Demographics
NPI:1336908433
Name:BEAUTIFULLY WELL PLLC
Entity Type:Organization
Organization Name:BEAUTIFULLY WELL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOUCHENOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-402-6462
Mailing Address - Street 1:1601 2ND AVE N STE 516
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3289
Mailing Address - Country:US
Mailing Address - Phone:406-315-1228
Mailing Address - Fax:
Practice Address - Street 1:1601 2ND AVE N STE 516
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3289
Practice Address - Country:US
Practice Address - Phone:406-315-1228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty