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NPI Code Detail

MEDICARE: AMBER PROSCENO LMT

MEDICARE:   AMBER  PROSCENO  LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMT115219TX

General Provider Information

NPI Number : 1427679224
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER PROSCENO LMT
Provider Business Mailing Address
First Line : 8700 MENCHACA RD STE 206
Second Line :
City : AUSTIN
State : TX
Zip : 78748-5373
Country : US
Telephone Number : 512-387-7037
Fax Number :
Provider Business Practice Location Address
First Line : 8700 MENCHACA RD STE 206
Second Line :
City : AUSTIN
State : TX
Zip : 78748-5373
Country : US
Telephone Number : 512-387-7037
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2020
Last Update Date : 05/03/2020

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Directions to “ AMBER PROSCENO LMT” Practice Location

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