Provider Demographics
NPI:1538725999
Name:MCANALLY, LENA (LMT,NMT)
Entity type:Individual
Prefix:
First Name:LENA
Middle Name:
Last Name:MCANALLY
Suffix:
Gender:F
Credentials:LMT,NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 GRIZZLY DR
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59404-3819
Mailing Address - Country:US
Mailing Address - Phone:406-468-8921
Mailing Address - Fax:
Practice Address - Street 1:316 CENTRAL AVE W
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59404-2845
Practice Address - Country:US
Practice Address - Phone:406-468-8921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-11
Last Update Date:2019-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-15856225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist