MEDICARE: SAVANNAH D PLENTY

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
1	225700000X	Massage Therapist	M05274	MD

General Provider Information

NPI Number	:	1578279766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAVANNAH D PLENTY

Provider Business Mailing Address
First Line	:	4266 HALLOWING POINT RD
Second Line	:
City	:	PRINCE FREDERICK
State	:	MD
Zip	:	20678-3439
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9505 REISTERSTOWN RD STE 3NW
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4451
Country	:	US
Telephone Number	:	667-206-0636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	01/30/2023

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Directions to “ SAVANNAH D PLENTY ” Practice Location

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