Provider Demographics
NPI:1861053084
Name:LINOSKI, AMBER CHRISTINE (LMT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:CHRISTINE
Last Name:LINOSKI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 MIDLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-2892
Mailing Address - Country:US
Mailing Address - Phone:248-804-2494
Mailing Address - Fax:
Practice Address - Street 1:1404 MIDLAND BLVD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-2892
Practice Address - Country:US
Practice Address - Phone:248-804-2494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501005484225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist