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General NPI Number Information
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NPI Number | 1780286948
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Entity Type | Individual
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Provider Name | CHERYL ANDERSON LMT
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Gender | Female
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Dates
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Enumeration Date | 11/12/2020
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 2301 E PRIEN LAKE RD
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City | LAKE CHARLES
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State | LA
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Zip | 70601-7976
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Country | US
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Telephone | 337-602-6959
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 528
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City | OBERLIN
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State | LA
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Zip | 70655-0528
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Country | US
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Telephone | 318-491-1314
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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 | 8901
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License Number State | LA
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