Provider Demographics
NPI:1114735529
Name:LUFFEY, SAVANNAH ROSE (MT)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:ROSE
Last Name:LUFFEY
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 OCALA RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5836
Mailing Address - Country:US
Mailing Address - Phone:804-317-8216
Mailing Address - Fax:
Practice Address - Street 1:8003 FRANKLIN FARMS DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5107
Practice Address - Country:US
Practice Address - Phone:804-945-0577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019013667225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist