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NPI Code Detail

MEDICARE: AMBER GAMBLE

MEDICARE: AMBER GAMBLE
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 Therapist151521AK

General Provider Information

NPI Number : 1689209702
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER GAMBLE
Provider Business Mailing Address
First Line : 5311 E 26TH AVE APT 7
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-3844
Country : US
Telephone Number : 907-782-7495
Fax Number :
Provider Business Practice Location Address
First Line : 13135 OLD GLENN HWY STE 100
Second Line :
City : EAGLE RIVER
State : AK
Zip : 99577-7584
Country : US
Telephone Number : 907-696-9090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2020
Last Update Date : 03/09/2020

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Directions to “ AMBER GAMBLE ” Practice Location

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