MEDICARE: MS. PATRICIA A ALLEN L.M.T.

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	MA29901	FL

General Provider Information

NPI Number	:	1457422107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA A ALLEN L.M.T.

Provider Business Mailing Address
First Line	:	447 27TH ST
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-5419
Country	:	US
Telephone Number	:	561-758-8042
Fax Number	:	561-832-5228

Provider Business Practice Location Address
First Line	:	537 US HIGHWAY 1
Second Line	:	SUITE 2
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-4903
Country	:	US
Telephone Number	:	561-848-9344
Fax Number	:

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	07/08/2007

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