Provider Demographics
NPI:1659638260
Name:VERMILYE, ANNE MARIE (LMT)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIE
Last Name:VERMILYE
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 1:4325 COMMERCE ST
Mailing Address - Street 2:SUITE 111-338
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-5467
Mailing Address - Country:US
Mailing Address - Phone:541-913-1397
Mailing Address - Fax:
Practice Address - Street 1:895 COUNTRY CLUB RD
Practice Address - Street 2:A140
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6003
Practice Address - Country:US
Practice Address - Phone:541-484-3055
Practice Address - Fax:541-225-5158
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18582172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist