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General NPI Number Information
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NPI Number | 1053083956
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Entity Type | Individual
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Provider Name | VICTORIA NICOLE SOMERS LMT
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Gender | Female
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Dates
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Enumeration Date | 09/29/2021
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Last Update Date | 10/01/2021
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Provider Practice Location Address
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Address Line | 7602 N TADLEY LN APT 308
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City | SPOTSYLVANIA
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State | VA
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Zip | 22551-2940
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Country | US
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Telephone | 540-907-6373
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Fax |
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Provider Business Mailing Address
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Address Line | 7602 N TADLEY LN APT 308
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City | SPOTSYLVANIA
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State | VA
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Zip | 22551-2940
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Country | US
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Telephone | 540-907-6373
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 0019010136
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License Number State | VA
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