Individual
TASHA NICHOLE KOHLWES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2360 MULLAN RD, MISSOULA, MT 59808-1811
(406) 532-8061
(406) 721-6053
Mailing address
2360 MULLAN RD, MISSOULA, MT 59808-1811
(406) 532-8061
(406) 721-6053
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
135
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000007166
BOARD OR CERTIFICATION
MT
Enumeration date
06/06/2019
Last updated
06/06/2019
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