MEDICARE: MRS. SHARON TASI

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

General Provider Information

NPI Number	:	1700186418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARON TASI

Provider Business Mailing Address
First Line	:	9067 US HIGHWAY 31
Second Line	:	SUITE # 209
City	:	BERRIEN SPRINGS
State	:	MI
Zip	:	49103-1664
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9067 US HIGHWAY 31
Second Line	:	SUITE # 209
City	:	BERRIEN SPRINGS
State	:	MI
Zip	:	49103-1664
Country	:	US
Telephone Number	:	269-449-1970
Fax Number	:

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

Provider Enumeration Date	:	10/27/2010
Last Update Date	:	10/27/2010

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