Individual
JOSHUA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1001 W OAK ST, BLDG. C STE. 210, BOZEMAN, MT 59715
(406) 587-8446
(406) 587-0898
Mailing address
1001 W OAK ST, BLDG. C STE. 210, BOZEMAN, MT 59715
(406) 587-8446
(406) 587-0898
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-LMT-LIC-13720
MT
Other
Enumeration date
04/01/2019
Last updated
04/01/2019
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