Provider Demographics
NPI:1912152992
Name:AHNER, PATRICIA (AP, LAC, LMT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:AHNER
Suffix:
Gender:F
Credentials:AP, LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5003 EDWARDS RD UNIT 20
Mailing Address - Street 2:
Mailing Address - City:TAYLORS
Mailing Address - State:SC
Mailing Address - Zip Code:29687-2869
Mailing Address - Country:US
Mailing Address - Phone:954-330-9425
Mailing Address - Fax:
Practice Address - Street 1:5003 EDWARDS RD UNIT 20
Practice Address - Street 2:
Practice Address - City:TAYLORS
Practice Address - State:SC
Practice Address - Zip Code:29687-2869
Practice Address - Country:US
Practice Address - Phone:954-330-9425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65.000136171100000X
FLAP2411171100000X
OH33.016553225700000X
FLMA34106225700000X
SC9602225700000X
SC241171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist