Most Relevant Information
Provider Data
| NPI Number: | 1003317868 |
| Provider Name: | SUSAN ANNETTE OLIVER LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 10572 |
Most Important Dates
| Enumeration Date: | 02/26/2018 |
| Last Updated: | 02/26/2018 |
Provider Practice Location
220 BROAD ST STE 203
KINGSPORT
TN
376604245
Practice Location Phone/Fax
| Phone: | 4233610545 |
| Fax: |
Provider Mailing Location
195 WOODMONT AVE
KINGSPORT
TN
376603224
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |