Provider Demographics
NPI:1750130522
Name:TAYLOR-ZWEEGMAN, JEWELL NINETTE
Entity type:Individual
Prefix:
First Name:JEWELL
Middle Name:NINETTE
Last Name:TAYLOR-ZWEEGMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 MILES AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-5032
Mailing Address - Country:US
Mailing Address - Phone:406-633-0051
Mailing Address - Fax:
Practice Address - Street 1:224 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-5951
Practice Address - Country:US
Practice Address - Phone:406-633-0051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-281225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty