Individual
SANDRA KATHLEEN SAMPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
207 N MAIN ST, BOULDER, MT 59632-7761
(406) 560-2164
Mailing address
207 N MAIN STREET, PO BOX 793, BOULDER, MT 59632
(406) 560-2164
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-LMT-LIC-4719
MT
Other
Enumeration date
08/05/2013
Last updated
07/01/2026
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