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General NPI Number Information
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NPI Number | 1548454911
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Entity Type | Individual
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Provider Name | AMY A. WARDWELL L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 8595 BEECHMONT AVE STE 200
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City | CINCINNATI
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State | OH
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Zip | 45255-4740
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Country | US
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Telephone | 513-752-1663
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Fax | 513-752-7728
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Provider Business Mailing Address
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Address Line | 3357 JENNY LIND RD
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City | AMELIA
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State | OH
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Zip | 45102-1848
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Country | US
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Telephone | 513-752-1663
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Fax | 513-752-7728
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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 | 33-00-7407
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License Number State | OH
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