Provider Demographics
NPI:1396530176
Name:MYOFASCIAL RELEASE WORKS
Entity type:Organization
Organization Name:MYOFASCIAL RELEASE WORKS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:406-403-2626
Mailing Address - Street 1:1816 COLUMBIA FALLS STAGE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-9342
Mailing Address - Country:US
Mailing Address - Phone:406-403-2626
Mailing Address - Fax:
Practice Address - Street 1:1816 COLUMBIA FALLS STAGE
Practice Address - Street 2:
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-9342
Practice Address - Country:US
Practice Address - Phone:406-403-2626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty