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General NPI Number Information
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NPI Number | 1891350062
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Entity Type | Individual
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Provider Name | ELIZABETH OSBURN RIGGINS LMT
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Gender | Female
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Dates
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Enumeration Date | 05/03/2019
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Last Update Date | 05/03/2019
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Provider Practice Location Address
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Address Line | 406 MAIN ST
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City | BLACKSHEAR
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State | GA
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Zip | 31516-1904
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Country | US
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Telephone | 912-282-9060
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Fax |
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Provider Business Mailing Address
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Address Line | 4472 MOLLY BRANCH RD
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City | BLACKSHEAR
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State | GA
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Zip | 31516-4134
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Country | US
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Telephone |
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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 | MT000535
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License Number State | GA
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