MEDICARE: AMY PIERZCHALSKI CMT

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	164.0000050	VT

General Provider Information

NPI Number	:	1306556477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY PIERZCHALSKI CMT

Provider Business Mailing Address
First Line	:	32 BROOKSIDE DR
Second Line	:
City	:	SHELDON
State	:	VT
Zip	:	05483-4410
Country	:	US
Telephone Number	:	802-752-7175
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 KELLOGG RD
Second Line	:
City	:	ESSEX JCT
State	:	VT
Zip	:	05452-2815
Country	:	US
Telephone Number	:	802-752-7175
Fax Number	:

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

Provider Enumeration Date	:	11/30/2022
Last Update Date	:	11/30/2022

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