KYLE PHILLIP DIETRICH (NPI# 1932661352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932661352 |
| Entity Type | Individual |
| Full Name | KYLE PHILLIP DIETRICH |
| Credential | LMT |
| Practice Address |
1203 Mount Ave Missoula MT 59801-5601 |
| Mailing Address |
320 Saints Loop Apt B Helena MT 59602-7657 |
| Practice Telephone | 6268182780 |
| Mailing Telephone | 6268182780 |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2019-04-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | LMT-LMT-LIC-1588 | MT | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1203 MOUNT AVE |
| City | MISSOULA |
| State | MT |
| Zip Code | 59801-5601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932264496 | Marquardt Chiropractic Clinic PC | Chiropractor | 1203 Mount Ave, Missoula, MT 59801 | 2006-12-26 |
| 1952966038 | Laurel Peterson | Massage Therapist | 1203 Mount Ave, Missoula, MT 59801-5601 | 2019-05-05 |
| 1669949483 | Michael Emery | Massage Therapist | 1203 Mount Ave, Missoula, MT 59801-5601 | 2018-10-30 |
| 1356858179 | Mage R Lee | Chiropractor | 1203 Mount Ave, Missoula, MT 59801-5601 | 2018-01-02 |
| 1952817439 | Dr. Mage R. Lee | Clinic/Center | 1203 Mount Ave, Missoula, MT 59801-5601 | 2017-12-20 |
| 1770850349 | Andriana Leigh Stube | Massage Therapist | 1203 Mount Ave, Missoula, MT 59801-5601 | 2011-11-25 |
| 1487959474 | Becci Snowden | Massage Therapist | 1203 Mount Ave, Missoula, MT 59801-5601 | 2011-01-21 |
| 1003040437 | Tiara Z Liberty | Massage Therapist | 1203 Mount Ave, Missoula, MT 59801-5601 | 2009-05-13 |
| 1861659211 | Jessica Lynne Cullinan | Massage Therapist | 1203 Mount Ave, Missoula, MT 59801-5601 | 2008-05-21 |
| 1255451738 | James P Marquardt | Chiropractor | 1203 Mount Ave, Missoula, MT 59801-5601 | 2007-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629681010 | Time To Thrive Pllc | Social Worker | 1836 South Ave. West, Missoula, MT 59801 | 2020-08-26 |
| 1740815653 | Yuzo Fujiki | Specialist/Technologist | 210 N California St 104, Missoula, MT 59801 | 2020-03-11 |
| 1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
| 1437668530 | Rejuve Care Clinic, Inc | Plastic Surgery | 715 Kensingten, Ste 1, Missoula, Missoula, MT 59801 | 2017-09-21 |
| 1619499555 | Beatrice Elise Powers | Specialist/Technologist | 410 B Stephens Ave, Missoula, MT 59801 | 2017-07-12 |
| 1770012197 | Hannah Lepiane | Massage Therapist | 1313 S. 4th W., Missoula, MT 59801 | 2017-06-08 |
| 1811420227 | Celeste Willis | Social Worker | 1055 W. Sussex, Missoula, MT 59801 | 2017-04-04 |
| 1073050498 | Rina Kasuga | Specialist/Technologist | 913 Rimini Ct, Missoula, MT 59801 | 2017-01-24 |
| 1043756919 | Heather Bartz | Specialist/Technologist | 831 Hastings Ave, Missoula, MT 59801 | 2017-01-16 |
| 1255874517 | Sarabeth Haddad | Social Worker | 1055 W Sussex Ave, Missoula, MT 59801 | 2016-11-18 |
| Find all providers in zip 59801 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982216834 | Rosemary A Stoudt | Massage Therapist | 415 N Higgins Ave Ste 128, Missoula, MT 59802-4563 | 2020-08-21 |
| 1114549540 | Rozanne Smith | Massage Therapist | 700 South Ave W Ste C, Missoula, MT 59801-8011 | 2020-05-07 |
| 1215584719 | Shelby Riley | Massage Therapist | 2801 S Russell St Ste 39, Missoula, MT 59801-7922 | 2019-08-20 |
| 1588229686 | Kayla Hull | Massage Therapist | 1940 Harve Ave Ste B, Missoula, MT 59801-8332 | 2019-05-03 |
| 1063984078 | Sarah Jane Hanlon | Massage Therapist | 801 Sherwood St Ste 1, Missoula, MT 59802-2659 | 2019-01-02 |
| 1184195182 | Deep Tissue Massage Group, Inc. | Massage Therapist | 725 W Alder St Ste 20, Missoula, MT 59802-4099 | 2018-12-17 |
| 1518435940 | Marc Benjamin Gonzalez | Massage Therapist | 397 Brianna Ct, Missoula, MT 59804-1041 | 2018-11-03 |
| 1780169847 | Cindy Ardis Clippinger | Massage Therapist | 4708 Sage St, Missoula, MT 59808-1475 | 2018-09-25 |
| 1881181444 | Carol Anne Lesser | Massage Therapist | 1918 Birch St, Missoula, MT 59802 | 2018-04-19 |
| 1700383940 | Kelsey Hamilton | Massage Therapist | 6945 Linda Vista Blvd, Missoula, MT 59803 | 2018-04-12 |
| Find all providers in MISSOULA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.