MEDICARE: MRS. SUSAN YVONNE CHRISTIANSON 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	MT4248	ME

General Provider Information

NPI Number	:	1649510660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN YVONNE CHRISTIANSON LMT

Provider Business Mailing Address
First Line	:	921 AUGUSTA RD
Second Line	:
City	:	ROME
State	:	ME
Zip	:	04963-3123
Country	:	US
Telephone Number	:	207-615-4310
Fax Number	:

Provider Business Practice Location Address
First Line	:	921 AUGUSTA RD
Second Line	:
City	:	ROME
State	:	ME
Zip	:	04963-3123
Country	:	US
Telephone Number	:	207-615-4310
Fax Number	:

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

Provider Enumeration Date	:	02/28/2013
Last Update Date	:	02/28/2013

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Directions to “ MRS. SUSAN YVONNE CHRISTIANSON LMT” Practice Location

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