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General NPI Number Information
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NPI Number | 1467142083
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Entity Type | Individual
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Provider Name | ERIN W O'BRIEN LMT
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Gender | Female
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 1722 S GLENSTONE AVE STE RR
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City | SPRINGFIELD
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State | MO
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Zip | 65804-1513
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Country | US
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Telephone | 417-322-4397
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Fax |
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Provider Business Mailing Address
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Address Line | 204 SMITH RD
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City | LEBANON
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State | MO
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Zip | 65536-2055
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Country | US
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Telephone | 417-322-4397
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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 | 2022045763
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License Number State | MO
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