MEDICARE: MRS. NATALIE LORRAINE LAWSON-JOHNSON L.M.T., H.M.L.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	MA 54824	FL

General Provider Information

NPI Number	:	1063645638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NATALIE LORRAINE LAWSON-JOHNSON L.M.T., H.M.L.T.

Provider Business Mailing Address
First Line	:	1011 TROUTMAN BLVD NE
Second Line	:	UNIT 206
City	:	PALM BAY
State	:	FL
Zip	:	32905-4727
Country	:	US
Telephone Number	:	321-848-8103
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 S HARBOR CITY BLVD
Second Line	:	SUITE 117
City	:	MELBOURNE
State	:	FL
Zip	:	32901-4749
Country	:	US
Telephone Number	:	321-848-8103
Fax Number	:

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

Provider Enumeration Date	:	08/31/2009
Last Update Date	:	08/31/2009

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