Individual
TERESA ANN WENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
217 S DUKE ST STE 104, SHEPHERDSTOWN, WV 25443-4849
(304) 362-3009
Mailing address
158 HEATH CT, CHARLES TOWN, WV 25414-4137
(130) 427-9639
Taxonomy
Speciality
Code
Description
License number
State
163WM1400X
Nurse Massage Therapist (NMT)
0001149304
VA
163WM1400X
Nurse Massage Therapist (NMT)
Primary
53092
WV
163WW0101X
Ambulatory Women's Health Care Registered Nurse
53092
WV
225700000X
Massage Therapist
0019019311
VA
225700000X
Massage Therapist
223-4023
WV
Other
Enumeration date
06/19/2023
Last updated
06/19/2023
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