Doctor Name: | MARY DOLORES MANCILLAS-LOVELESS |
NPI Number: | 1952683542 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PTA, LMT, C.PED |
License Number: | 568 |
Business Practice Address: | 612 1st Ave. So. Great Falls, MT - 59401 |
Business Phone Number: | 4067502655 |
Business Fax Number: | |
Mailing Address: | 3026 4th Avenue South, GREAT FALLS |
State: | MT |
Postal Code: | 594053330 |
Phone Number: | 4067502655 |
Fax Number: | |
NPI Enumeration Date: | 09/09/2011 |
NPI Last Update Date: | 09/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 568 |
Healthcare Provider Taxonomy: (Secondary) | N |
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. |