Provider Demographics
NPI:1932733508
Name:SAINT JOHNS, AMBER CHRISTINE (LPTA LMT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:CHRISTINE
Last Name:SAINT JOHNS
Suffix:
Gender:F
Credentials:LPTA LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 SHARP RD
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-9669
Mailing Address - Country:US
Mailing Address - Phone:268-744-0025
Mailing Address - Fax:
Practice Address - Street 1:3223 SHARP RD
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-9669
Practice Address - Country:US
Practice Address - Phone:268-744-0025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-23
Last Update Date:2020-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501009304225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
04231971OtherOTHER