Provider Demographics
NPI:1831791391
Name:WINSKE, EMMA
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:WINSKE
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 1:108 1/2 W CALLENDER ST APT 7
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-2647
Mailing Address - Country:US
Mailing Address - Phone:715-869-0030
Mailing Address - Fax:
Practice Address - Street 1:1823 W COLLEGE ST # 100
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4915
Practice Address - Country:US
Practice Address - Phone:406-556-0562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-16323225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist