Provider Demographics
NPI:1336682756
Name:SANTURE, VERONICA LOVETT (LMT)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:LOVETT
Last Name:SANTURE
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 1:3022 ALBACORE CIR APT B3
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98315-9703
Mailing Address - Country:US
Mailing Address - Phone:912-342-3182
Mailing Address - Fax:
Practice Address - Street 1:3022 ALBACORE CIR APT B3
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98315-9703
Practice Address - Country:US
Practice Address - Phone:912-342-3182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60683867225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist