Provider Demographics
NPI:1487374476
Name:SEGGERMAN, AMY BETH (LMT)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:BETH
Last Name:SEGGERMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:BETH
Other - Last Name:PEET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1230 COLUMBIA AVE E STE A
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5188
Mailing Address - Country:US
Mailing Address - Phone:269-964-1441
Mailing Address - Fax:269-964-0137
Practice Address - Street 1:1230 COLUMBIA AVE E STE A
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5188
Practice Address - Country:US
Practice Address - Phone:269-964-1441
Practice Address - Fax:269-964-0137
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225700000X
MI7501011270225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist