Doctor Name: | MARY ELLEN HENDRICKSON |
NPI Number: | 1023365277 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | 902 |
Business Practice Address: | 1623 13th Ave S Great Falls, MT - 594054705 |
Business Phone Number: | 4067882214 |
Business Fax Number: | 4067271324 |
Mailing Address: | 1623 13th Ave S, GREAT FALLS |
State: | MT |
Postal Code: | 594054705 |
Phone Number: | 4067882214 |
Fax Number: | 4067271324 |
NPI Enumeration Date: | 08/07/2012 |
NPI Last Update Date: | 08/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 902 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |