MEDICARE: LASHUAN SMITH LVN, LMT

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

General Provider Information

NPI Number	:	1093608952
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LASHUAN SMITH LVN, LMT

Provider Business Mailing Address
First Line	:	1000 CRAIG ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23523-1315
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 CRAIG ST
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23523-1315
Country	:	US
Telephone Number	:	214-293-4361
Fax Number	:

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

Provider Enumeration Date	:	05/30/2025
Last Update Date	:	05/30/2025

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