Provider Demographics
NPI:1730881517
Name:MOUA INSTITUTE OF MASSAGE PLLC
Entity type:Organization
Organization Name:MOUA INSTITUTE OF MASSAGE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:MAY
Authorized Official - Last Name:MOUA
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, EDD
Authorized Official - Phone:406-234-6467
Mailing Address - Street 1:1807 N STREVELL AVE
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-5426
Mailing Address - Country:US
Mailing Address - Phone:785-226-0554
Mailing Address - Fax:
Practice Address - Street 1:907 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-3345
Practice Address - Country:US
Practice Address - Phone:406-234-6467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty