MEDICARE: ADRIENNE LEIGH OSBORN LMT, CLT

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	13351	SC

General Provider Information

NPI Number	:	1811713340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIENNE LEIGH OSBORN LMT, CLT

Provider Business Mailing Address
First Line	:	244 COOPER RUN RD
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29909-7856
Country	:	US
Telephone Number	:	843-301-3184
Fax Number	:

Provider Business Practice Location Address
First Line	:	2206 MOSSY OAKS RD STE 8
Second Line	:
City	:	PORT ROYAL
State	:	SC
Zip	:	29935-1046
Country	:	US
Telephone Number	:	843-301-3184
Fax Number	:

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

Provider Enumeration Date	:	11/30/2024
Last Update Date	:	11/30/2024

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