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Individual

LISA LOUISE WORTMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
810 N WALLACE AVE, BOZEMAN, MT 59715-3020
(406) 920-0614
Mailing address
705 E MENDENHALL ST # A, BOZEMAN, MT 59715-3820
(406) 920-0614

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2960
MT

Other

Enumeration date
02/19/2021
Last updated
12/01/2021
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