MEDICARE: MS. NICOLE BINDLER 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	MSG010476	PA

General Provider Information

NPI Number	:	1497418131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NICOLE BINDLER LMT

Provider Business Mailing Address
First Line	:	1718 S CLEVELAND ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19145-2107
Country	:	US
Telephone Number	:	857-928-2288
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 CHESTNUT ST STE 204
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19106-3051
Country	:	US
Telephone Number	:	215-627-3782
Fax Number	:

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

Provider Enumeration Date	:	10/19/2021
Last Update Date	:	10/19/2021

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