Provider Demographics
NPI:1780169847
Name:CLIPPINGER, CINDY ARDIS (LMT)
Entity type:Individual
Prefix:MISS
First Name:CINDY
Middle Name:ARDIS
Last Name:CLIPPINGER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4708 SAGE ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1475
Mailing Address - Country:US
Mailing Address - Phone:406-926-1622
Mailing Address - Fax:
Practice Address - Street 1:4708 SAGE ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1475
Practice Address - Country:US
Practice Address - Phone:406-926-1622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLIC9872225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist