NPI 1053726323

Derek Gene Smith, LMT

Practitioner Massage Therapist Missoula, MT

Practice location

Address: 2801 Great Northern Loop, Missoula, MT 59808-1745
Phone: (406) 549-9100
Fax: (406) 549-9151

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence LMT-LMT-LIC-6151 (MT)

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Registry record

NPI: 1053726323
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Jun 2014
Record last updated: 25 Jun 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.