Provider Demographics
NPI:1700901972
Name:GOSS, AMBER DANIELLE
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:DANIELLE
Last Name:GOSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 BLUE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:MILROY
Mailing Address - State:PA
Mailing Address - Zip Code:17063-9231
Mailing Address - Country:US
Mailing Address - Phone:717-667-2605
Mailing Address - Fax:
Practice Address - Street 1:217 GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:YEAGERTOWN
Practice Address - State:PA
Practice Address - Zip Code:17099-9635
Practice Address - Country:US
Practice Address - Phone:717-248-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist