Individual
HEIDI ANNETTE WAGONHAUSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1400 29TH ST S FL 2, GREAT FALLS, MT 59405-5353
(406) 761-3767
(406) 761-3038
Mailing address
1400 29TH ST S FL 2, GREAT FALLS, MT 59405-5353
(406) 761-3767
(406) 761-3038
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
634
MT
Other
Enumeration date
08/02/2011
Last updated
08/02/2011
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