MEDICARE: LAURI A. MCGRATH 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	MT4646	ME

General Provider Information

NPI Number	:	1730462813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURI A. MCGRATH LMT

Provider Business Mailing Address
First Line	:	600 TURNER ST STE 3
Second Line	:
City	:	AUBURN
State	:	ME
Zip	:	04210-5093
Country	:	US
Telephone Number	:	207-376-3233
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 TURNER ST STE 3
Second Line	:
City	:	AUBURN
State	:	ME
Zip	:	04210-5093
Country	:	US
Telephone Number	:	207-376-3233
Fax Number	:

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

Provider Enumeration Date	:	09/24/2011
Last Update Date	:	09/24/2011

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