MEDICARE: MR. NICHOLAS CIRANNI 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	33.004460	OH

General Provider Information

NPI Number	:	1598147761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NICHOLAS CIRANNI LMT

Provider Business Mailing Address
First Line	:	136 GRANVILLE ST
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-6504
Country	:	US
Telephone Number	:	614-471-9800
Fax Number	:	614-471-9815

Provider Business Practice Location Address
First Line	:	136 GRANVILLE ST
Second Line	:
City	:	GAHANNA
State	:	OH
Zip	:	43230-6504
Country	:	US
Telephone Number	:	614-471-9800
Fax Number	:	614-471-9815

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

Provider Enumeration Date	:	06/24/2015
Last Update Date	:	06/24/2015

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