Individual
TINA CECILIE WAMBEKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
119 S. MAIN ST., RESTORATION MASSAGE THERAPY, LLC, THREE FORKS, MT 59752
(406) 285-4263
(406) 285-4628
Mailing address
119 S. MAIN ST., P.O. BOX 863, THREE FORKS, MT 59752-0863
(406) 285-4263
(406) 285-4628
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
1232
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LICENSE 1232
MONTANA BOARD OF MASSAGE THERAPY
MT
01
—
LICENSE 7956
BOARD OF MEDICAL EXAMINERS, EMERGENCY MEDICAL TECHNICIAN- BASIC
MT
Enumeration date
01/19/2012
Last updated
01/19/2012
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