Provider Demographics
NPI:1801309661
Name:THIERFELDER, AYLEE MARIE (LAC)
Entity type:Individual
Prefix:MRS
First Name:AYLEE
Middle Name:MARIE
Last Name:THIERFELDER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:AYLEE
Other - Middle Name:MARIE
Other - Last Name:MCFADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:727 3RD ST W
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-3116
Mailing Address - Country:US
Mailing Address - Phone:406-249-3692
Mailing Address - Fax:
Practice Address - Street 1:110 2ND ST E
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2410
Practice Address - Country:US
Practice Address - Phone:406-863-6001
Practice Address - Fax:406-451-0333
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMED-ACU-LIC-78512171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist