MEDICARE: MS. CAROL MCGEE LIS. MASSAGE THERAPI

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	95649	FL
2	225700000X	Massage Therapist	MA95649	FL
3	225700000X	Massage Therapist	2284	AL

General Provider Information

NPI Number	:	1437341021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROL MCGEE LIS. MASSAGE THERAPI

Provider Business Mailing Address
First Line	:	3907 HUSSEY RD
Second Line	:
City	:	GREENWOOD
State	:	FL
Zip	:	32443-2117
Country	:	US
Telephone Number	:	256-394-0911
Fax Number	:

Provider Business Practice Location Address
First Line	:	3907 HUSSEY RD
Second Line	:
City	:	GREENWOOD
State	:	FL
Zip	:	32443-2117
Country	:	US
Telephone Number	:	256-394-0911
Fax Number	:

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

Provider Enumeration Date	:	08/16/2007
Last Update Date	:	04/20/2022

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