Provider Demographics
NPI:1538579198
Name:TRAFFORD, CHRISTINE MARIE (BS LMT)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:TRAFFORD
Suffix:
Gender:F
Credentials:BS LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W GOLD ST
Mailing Address - Street 2:STE A
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-2302
Mailing Address - Country:US
Mailing Address - Phone:406-491-4972
Mailing Address - Fax:
Practice Address - Street 1:700 W GOLD ST
Practice Address - Street 2:STE A
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-2302
Practice Address - Country:US
Practice Address - Phone:406-491-4927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-05
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-6185225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist