MEDICARE: MARSHALLA ANN ROBINSON 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	MT043904	TX

General Provider Information

NPI Number	:	1215542949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARSHALLA ANN ROBINSON LMT

Provider Business Mailing Address
First Line	:	2310 YUMA
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76504-1121
Country	:	US
Telephone Number	:	512-920-9774
Fax Number	:

Provider Business Practice Location Address
First Line	:	3425 BEE CAVES RD STE B2
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-6693
Country	:	US
Telephone Number	:	512-348-7682
Fax Number	:

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

Provider Enumeration Date	:	09/10/2020
Last Update Date	:	09/10/2020

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