Robert Steudle, LMT
Individual provider Active NPI Massage Therapist · Appling, GA
NPI 1174368294 · NPPES record last updated Jun 29, 2024
Key facts
- NPI
- 1174368294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MT007703 (GA)
- Practice address
- 6952 Moontown Dr E
Appling, GA 30802-2403 - Phone
- (706) 627-0071
- NPI assigned
- Jun 29, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7830 | SC | MD | Physical Therapist |
| MT007703 | GA | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 7830 | SC | |
| Massage Therapist | 225700000X | MT007703 | GA | Yes |
Addresses
Primary practice location
6952 Moontown Dr E
Appling, GA 30802-2403
Mailing address
6952 Moontown Dr E
Appling, GA 30802-2403
Phone (706) 627-0071
Other providers in Appling, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.