Provider Demographics
NPI:1518384379
Name:CRAIN, ANNA PAIGE (LAC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:PAIGE
Last Name:CRAIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3031 S RUSSELL ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-8523
Mailing Address - Country:US
Mailing Address - Phone:406-728-1600
Mailing Address - Fax:406-327-6702
Practice Address - Street 1:3031 S RUSSELL ST
Practice Address - Street 2:SUITE 1
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8523
Practice Address - Country:US
Practice Address - Phone:406-728-1600
Practice Address - Fax:406-327-6702
Is Sole Proprietor?:No
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT32323171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist