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Individual

ETHAN BLALOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1601 2ND AVE N FL 5, GREAT FALLS, MT 59401-3259
(406) 315-1228
Mailing address
3805 7TH ST NE TRLR 170, GREAT FALLS, MT 59404-1179

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-LMT-LIC-32009
MT

Other

Enumeration date
02/25/2026
Last updated
02/25/2026
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