Provider Demographics
NPI:1679068357
Name:ARMSTRONG, GENTRI
Entity type:Individual
Prefix:
First Name:GENTRI
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4426 WESTHILLS TRL
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-5325
Mailing Address - Country:US
Mailing Address - Phone:806-681-3286
Mailing Address - Fax:
Practice Address - Street 1:6666 W AMARILLO BLVD UNIT 1
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1752
Practice Address - Country:US
Practice Address - Phone:806-681-3286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT102899225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist