Provider Demographics
NPI:1588913966
Name:PHILLIPS, BARBARA A (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:A
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 MAIN ST SW
Mailing Address - Street 2:
Mailing Address - City:RONAN
Mailing Address - State:MT
Mailing Address - Zip Code:59864-2709
Mailing Address - Country:US
Mailing Address - Phone:406-544-3987
Mailing Address - Fax:
Practice Address - Street 1:426 MAIN ST., SW
Practice Address - Street 2:
Practice Address - City:RONAN
Practice Address - State:MT
Practice Address - Zip Code:59864-2709
Practice Address - Country:US
Practice Address - Phone:406-544-3987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT600171W00000X
MT225700000X171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor