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General NPI Number Information
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NPI Number | 1811713340
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Entity Type | Individual
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Provider Name | ADRIENNE LEIGH OSBORN LMT, CLT
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Gender | Female
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Dates
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Enumeration Date | 11/30/2024
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Last Update Date | 11/30/2024
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Provider Practice Location Address
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Address Line | 2206 MOSSY OAKS RD STE 8
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City | PORT ROYAL
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State | SC
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Zip | 29935-1046
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Country | US
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Telephone | 843-301-3184
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Fax |
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Provider Business Mailing Address
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Address Line | 244 COOPER RUN RD
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City | BLUFFTON
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State | SC
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Zip | 29909-7856
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Country | US
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Telephone | 843-301-3184
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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 | 13351
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License Number State | SC
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