MEDICARE: DEE WARTENBERG BS, NCTMB, RM

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	:	1144322041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEE WARTENBERG BS, NCTMB, RM

Provider Business Mailing Address
First Line	:	827 JACKSON ST
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18102-4839
Country	:	US
Telephone Number	:	610-737-7541
Fax Number	:

Provider Business Practice Location Address
First Line	:	827 JACKSON ST
Second Line	:
City	:	ALLENTOWN
State	:	PA
Zip	:	18102-4839
Country	:	US
Telephone Number	:	610-737-7541
Fax Number	:

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	07/08/2007

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