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NPI Code Detail

MEDICARE: RHIANNON LEA ROBERTS LMT

MEDICARE: RHIANNON LEA ROBERTS 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
1225700000XMassage Therapist2238LA

General Provider Information

NPI Number : 1205088820
Entity Type Code : Individual
Provider Name (Legal Business Name) : RHIANNON LEA ROBERTS LMT
Provider Business Mailing Address
First Line : 614 ESPLANADE ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70607-6308
Country : US
Telephone Number : 337-540-9253
Fax Number :
Provider Business Practice Location Address
First Line : 614 ESPLANADE ST
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70607-6308
Country : US
Telephone Number : 337-540-9253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/14/2008
Last Update Date : 10/14/2008

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Directions to “ RHIANNON LEA ROBERTS LMT” Practice Location

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