Provider Demographics
NPI:1306375613
Name:TURNER, AMIE MICHELLE (LMT)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:MICHELLE
Last Name:TURNER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 HARVARD ST APT 9
Mailing Address - Street 2:
Mailing Address - City:BANDON
Mailing Address - State:OR
Mailing Address - Zip Code:97411-9142
Mailing Address - Country:US
Mailing Address - Phone:541-435-4422
Mailing Address - Fax:
Practice Address - Street 1:1502 HARVARD ST APT 9
Practice Address - Street 2:
Practice Address - City:BANDON
Practice Address - State:OR
Practice Address - Zip Code:97411-9142
Practice Address - Country:US
Practice Address - Phone:541-435-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR17842225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist