Individual
CORINNE BOGNACKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1520 W LAKESHORE DR, WHITEFISH, MT 59937-2261
(310) 804-6562
Mailing address
1520 W LAKESHORE DR, WHITEFISH, MT 59937-2261
(310) 804-6562
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18456
MT
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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