MEDICARE: AMBER JENKINS 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
1	225700000X	Massage Therapist		OH

General Provider Information

NPI Number	:	1861112211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER JENKINS LMT

Provider Business Mailing Address
First Line	:	2159 CAPESTRANO DR
Second Line	:
City	:	XENIA
State	:	OH
Zip	:	45385-1107
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5727 BIGGER RD
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45440-2752
Country	:	US
Telephone Number	:	937-999-8136
Fax Number	:

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

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	08/29/2022

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Directions to “ AMBER JENKINS LMT” Practice Location

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