MEDICARE: SANDRA MARIE THOMPSON 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	MSG009502	PA

General Provider Information

NPI Number	:	1114325719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA MARIE THOMPSON LMT

Provider Business Mailing Address
First Line	:	272 HANNAHSTOWN RD
Second Line	:
City	:	CABOT
State	:	PA
Zip	:	16023-2118
Country	:	US
Telephone Number	:	724-814-2784
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 IDAHO AVE
Second Line	:
City	:	NATRONA HEIGHTS
State	:	PA
Zip	:	15065-1343
Country	:	US
Telephone Number	:	724-904-7356
Fax Number	:

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

Provider Enumeration Date	:	12/12/2014
Last Update Date	:	12/12/2014

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