MEDICARE: DAVID H. HEARNE 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	014325-1	NY

General Provider Information

NPI Number	:	1164491197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID H. HEARNE LMT

Provider Business Mailing Address
First Line	:	1224 STOCKBRIDGE RD
Second Line	:
City	:	WEBSTER
State	:	NY
Zip	:	14580-9145
Country	:	US
Telephone Number	:	585-749-6739
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 HELENDALE RD
Second Line	:	SUITE 150
City	:	ROCHESTER
State	:	NY
Zip	:	14609-3173
Country	:	US
Telephone Number	:	585-749-6739
Fax Number	:

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	07/08/2007

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