Individual
LISA SOUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
630 BOARDWALK AVE STE 1, BOZEMAN, MT 59718-4118
(406) 600-7267
Mailing address
PO BOX 11085, BOZEMAN, MT 59719-1085
(406) 600-7267
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
MT
Other
Enumeration date
03/09/2021
Last updated
03/09/2021
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