Provider Demographics
NPI:1053164145
Name:SAVAGE, ALLIE (LMT)
Entity type:Individual
Prefix:
First Name:ALLIE
Middle Name:
Last Name:SAVAGE
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 1:612 N 1ST ST
Mailing Address - Street 2:SUITE 2 - 103
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840
Mailing Address - Country:US
Mailing Address - Phone:406-552-8828
Mailing Address - Fax:
Practice Address - Street 1:274 OLD CORVALLIS RD STE F
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-3213
Practice Address - Country:US
Practice Address - Phone:406-552-8828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-15764225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist