Individual provider · Type 1 NPI

Teriesa Black Runyan, LMT

Massage Therapist · Great Falls, MT

NPI number 1902412141 Active

Practice location

1308 12th Ave S
Great Falls, MT 59405-4607

Call (406) 453-8885 Map

Mailing address

612 Willow Creek Ct
Great Falls, MT 59405-1316

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist 225700000X260024-4701 (UT)
Massage Therapist Primary 225700000XLMT-LMT-LIC-17904 (MT)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1902412141

Teriesa Black Runyan, LMT's National Provider Identifier is 1902412141, issued on Sep 22, 2020. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Great Falls, MT. The record was last updated on Sep 22, 2020.