Individual
MERCEDES MCCANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
24 S WILLSON AVE, BOZEMAN, MT 59715-4665
(406) 579-9420
Mailing address
PO BOX 11205, BOZEMAN, MT 59719-1205
(406) 579-9420
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-LMT-LIC-3994
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMT-LMT-LIC-3994
STATE OF MONTANA
MT
Enumeration date
03/06/2021
Last updated
03/06/2021
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