Provider Demographics
NPI:1568582005
Name:ERB, BERNICE CAROL (LMT)
Entity Type:Individual
Prefix:MRS
First Name:BERNICE
Middle Name:CAROL
Last Name:ERB
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MRS
Other - First Name:BERNICE
Other - Middle Name:CAROL
Other - Last Name:ERB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:7762 WILDCREEK TRL SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-3927
Mailing Address - Country:US
Mailing Address - Phone:256-585-4068
Mailing Address - Fax:
Practice Address - Street 1:7762 WILDCREEK TRL SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-3927
Practice Address - Country:US
Practice Address - Phone:256-585-4068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2325225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist