Provider Demographics
NPI:1922982958
Name:BLUE DRAGON FAMILY MASSAGE LLC
Entity type:Organization
Organization Name:BLUE DRAGON FAMILY MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANTONIA L
Authorized Official - Last Name:HOENKE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:406-438-7850
Mailing Address - Street 1:1325 EUCLID AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-2101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:406-389-8942
Practice Address - Street 1:1325 EUCLID AVE STE 5
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-2101
Practice Address - Country:US
Practice Address - Phone:406-438-7850
Practice Address - Fax:406-389-8942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-04
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty