Individual
MRS. AMANDA FISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
409 1ST AVE E STE A, KALISPELL, MT 59901-4918
(406) 270-2523
Mailing address
409 1ST AVE E STE A, KALISPELL, MT 59901-4918
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-LMT-LIC-10118
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13918855
CAQH
MT
Enumeration date
10/30/2016
Last updated
10/30/2016
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