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NPI Code Detail

MEDICARE: TRENIA O'DELL-GIFFORD LMT

MEDICARE:   TRENIA  O'DELL-GIFFORD  LMT
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 Therapist2005-1890WV

General Provider Information

NPI Number : 1477097640
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRENIA O'DELL-GIFFORD LMT
Provider Business Mailing Address
First Line : PO BOX 496
Second Line :
City : SAINT ALBANS
State : WV
Zip : 25177-0496
Country : US
Telephone Number : 304-421-5953
Fax Number :
Provider Business Practice Location Address
First Line : 2227 KANAWHA TER
Second Line :
City : SAINT ALBANS
State : WV
Zip : 25177-3186
Country : US
Telephone Number : 304-421-5953
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2016
Last Update Date : 12/07/2016

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Directions to “ TRENIA O'DELL-GIFFORD LMT” Practice Location

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