Healthcare Provider Details

I. General information

NPI: 1912452848
Provider Name (Legal Business Name): SUSAN ELIZABEH NOTTINGHAM LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2016
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 MIAMISBURG CENTERVILLE RD
DAYTON OH
45459-3816
US

IV. Provider business mailing address

5980 CINDY DR
DAYTON OH
45449-3207
US

V. Phone/Fax

Practice location:
  • Phone: 937-671-2701
  • Fax:
Mailing address:
  • Phone: 937-825-2022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33.019806
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: