Provider Demographics
NPI:1104104397
Name:ARMSTRONG, REBECCA LEE (LMT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:LEE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 18TH AVE SW
Mailing Address - Street 2:SUITE B
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701-6278
Mailing Address - Country:US
Mailing Address - Phone:701-838-7007
Mailing Address - Fax:
Practice Address - Street 1:304 18TH AVE SW
Practice Address - Street 2:SUITE B
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701-6278
Practice Address - Country:US
Practice Address - Phone:701-838-7007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND423225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist