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Individual

PROF. PATRICIA E MACMILLAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RMT

Contact information

Practice address
329 S 2ND ST W, MISSOULA, MT 59801-1839
(406) 542-9177
Mailing address
329 S 2ND ST W, MISSOULA, MT 59801-1839
(406) 542-9177

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1919
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
616580000
FEDERAL WORKMANS COMPENSATION PROVIDER
MT
Enumeration date
03/25/2014
Last updated
03/25/2014
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