MEDICARE: KIM CASTANEL MASSAGE THERAPIST

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	7380	LA

General Provider Information

NPI Number	:	1710571328
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM CASTANEL MASSAGE THERAPIST

Provider Business Mailing Address
First Line	:	7326 TRAPIER AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-1638
Country	:	US
Telephone Number	:	504-708-8858
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 LAKE VILLA DR STE 203
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70002-5549
Country	:	US
Telephone Number	:	504-708-8858
Fax Number	:

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

Provider Enumeration Date	:	02/24/2021
Last Update Date	:	02/24/2021

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Directions to “ KIM CASTANEL MASSAGE THERAPIST” Practice Location

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