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General NPI Number Information
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NPI Number | 1558645390
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Entity Type | Individual
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Provider Name | VIRGINIA C SHILTZ LMT-2005-1946
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Gender | Female
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | RR 3 BOX 308A
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City | MILTON
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State | WV
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Zip | 25541-9518
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Country | US
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Telephone | 304-638-2113
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Fax |
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Provider Business Mailing Address
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Address Line | RR 3 BOX 308A
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City | MILTON
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State | WV
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Zip | 25541-9518
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Country | US
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Telephone | 304-638-2113
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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 | 2005-1946
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License Number State | WV
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