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General NPI Number Information
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NPI Number | 1528295276
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Entity Type | Individual
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Provider Name | CLEO ANNETTE PIKE LMT
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Gender | Female
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Dates
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Enumeration Date | 06/19/2009
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Last Update Date | 06/19/2009
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Provider Practice Location Address
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Address Line | 201B 6TH ST
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City | POINT PLEASANT
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State | WV
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Zip | 25550-1108
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Country | US
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Telephone | 304-675-1411
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Fax |
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Provider Business Mailing Address
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Address Line | 201 GALA LANE
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City | ASHTON
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State | WV
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Zip | 25503
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Country | US
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Telephone | 304-576-2765
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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 | 2006-1978
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License Number State | WV
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