MEDICARE: BARBARA LOUISE RUBIN L.M.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	5690	OR

General Provider Information

NPI Number	:	1043457435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA LOUISE RUBIN L.M.T.

Provider Business Mailing Address
First Line	:	5 E 24TH AVE
Second Line	:	SUITE 3
City	:	EUGENE
State	:	OR
Zip	:	97405-2907
Country	:	US
Telephone Number	:	541-968-6674
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 E 24TH AVE
Second Line	:	SUITE 3
City	:	EUGENE
State	:	OR
Zip	:	97405-2907
Country	:	US
Telephone Number	:	541-968-6674
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2009
Last Update Date	:	01/07/2009

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