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NPI Code Detail

MEDICARE: AMBER D TRUDO CMT

MEDICARE:   AMBER D TRUDO  CMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist164.0000086VT

General Provider Information

NPI Number : 1184317083
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER D TRUDO CMT
Provider Business Mailing Address
First Line : 380 CROWN POINT RD UNIT B
Second Line :
City : BRIDPORT
State : VT
Zip : 05734-9477
Country : US
Telephone Number : 802-989-2517
Fax Number :
Provider Business Practice Location Address
First Line : 380 CROWN POINT RD UNIT B
Second Line :
City : BRIDPORT
State : VT
Zip : 05734-9477
Country : US
Telephone Number : 802-989-2517
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2023
Last Update Date : 05/29/2023

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Directions to “ AMBER D TRUDO CMT” Practice Location

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