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General NPI Number Information
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NPI Number | 1134955487
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Entity Type | Individual
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Provider Name | AMBER SNODGRASS L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 09/12/2024
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Last Update Date | 09/21/2024
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Provider Practice Location Address
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Address Line | 601 50TH ST SE
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City | CHARLESTON
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State | WV
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Zip | 25304-2025
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Country | US
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Telephone | 304-951-4401
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 231
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City | CABIN CREEK
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State | WV
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Zip | 25035-0231
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Country | US
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Telephone | 304-951-4401
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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 | 2020-3806
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License Number State | WV
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