MEDICARE: HEALING HANDS MASSAGE & SPA, LLC

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	007849	NY

General Provider Information

NPI Number	:	1396044699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING HANDS MASSAGE & SPA, LLC

Provider Business Mailing Address
First Line	:	46 W BUFFALO ST
Second Line	:
City	:	WARSAW
State	:	NY
Zip	:	14569-1209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	46 W BUFFALO ST
Second Line	:
City	:	WARSAW
State	:	NY
Zip	:	14569-1209
Country	:	US
Telephone Number	:	585-786-3590
Fax Number	:

Authorized Official
Title or Position	:	MABAGING MEMBER
Name	:	BRIDGET EILEEN BARNES
Credential	:
Telephone Number	:	585-786-3590

Provider Enumeration Date	:	03/25/2011
Last Update Date	:	03/25/2011

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