Provider Demographics
NPI:1679060727
Name:FIX, JAMES VANARD (CST)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:VANARD
Last Name:FIX
Suffix:
Gender:M
Credentials:CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 E MAIN ST STE 314
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4420
Mailing Address - Country:US
Mailing Address - Phone:406-210-9805
Mailing Address - Fax:
Practice Address - Street 1:127 E MAIN ST STE 314
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4420
Practice Address - Country:US
Practice Address - Phone:406-210-9805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-15
Last Update Date:2018-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist