Provider Demographics
NPI:1477938652
Name:KAY, DANIEL WALTER (LMT)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:WALTER
Last Name:KAY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6225 HAZELWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LOLO
Mailing Address - State:MT
Mailing Address - Zip Code:59847-9674
Mailing Address - Country:US
Mailing Address - Phone:406-273-6816
Mailing Address - Fax:
Practice Address - Street 1:6225 HAZELWOOD CT
Practice Address - Street 2:
Practice Address - City:LOLO
Practice Address - State:MT
Practice Address - Zip Code:59847-9674
Practice Address - Country:US
Practice Address - Phone:406-273-6816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-8154225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist