MEDICARE: MS. KAREN MICHELLE CASTRO 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	173C00000X	Reflexologist	5434	LA
2	225700000X	Massage Therapist	5434	LA

General Provider Information

NPI Number	:	1619716107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN MICHELLE CASTRO LMT

Provider Business Mailing Address
First Line	:	218 RUE LOUIS XIV STE A
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-5766
Country	:	US
Telephone Number	:	337-295-3330
Fax Number	:

Provider Business Practice Location Address
First Line	:	218 RUE LOUIS XIV STE A
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-5766
Country	:	US
Telephone Number	:	337-295-3330
Fax Number	:

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

Provider Enumeration Date	:	05/23/2024
Last Update Date	:	05/23/2024

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