Provider Demographics
NPI:1043013808
Name:YATES, BRANDY LYNN (LMT)
Entity type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:LYNN
Last Name:YATES
Suffix:
Gender:
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:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:MT
Mailing Address - Zip Code:59759-0111
Mailing Address - Country:US
Mailing Address - Phone:406-491-2249
Mailing Address - Fax:
Practice Address - Street 1:105 W LEGION ST STE C
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:MT
Practice Address - Zip Code:59759-9735
Practice Address - Country:US
Practice Address - Phone:406-491-2249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLMT-LMT-LIC-8542225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist