Doctor Name: | AMANDA SKORUPSKI |
NPI Number: | 1205209699 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | MT008258 |
Business Practice Address: | 1049 Daniel Wallace Rd Nw Townsend, GA - 313317408 |
Business Phone Number: | 9122306490 |
Business Fax Number: | |
Mailing Address: | Po Box 734, DARIEN |
State: | GA |
Postal Code: | 313050734 |
Phone Number: | 9122611017 |
Fax Number: | 9125543980 |
NPI Enumeration Date: | 11/05/2015 |
NPI Last Update Date: | 05/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MT008258 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |