MEDICARE: ROBYN RAE SWANEY CMT

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	62267	CA

General Provider Information

NPI Number	:	1679241582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBYN RAE SWANEY CMT

Provider Business Mailing Address
First Line	:	3153 EDISON AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-2523
Country	:	US
Telephone Number	:	707-245-1526
Fax Number	:

Provider Business Practice Location Address
First Line	:	3153 EDISON AVE
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95821-2523
Country	:	US
Telephone Number	:	707-245-1526
Fax Number	:

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

Provider Enumeration Date	:	09/03/2021
Last Update Date	:	09/03/2021

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