Individual
JESSIE VAILLANCOURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
318 PERKINS CREEK RD, ALBERTON, MT 59820
(406) 722-4451
Mailing address
PO BOX 116, ALBERTON, MT 59820-0116
(406) 381-0394
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-LMY-LIC-15823
MT
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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