MEDICARE: MR. KYLE ANDREW CARTHENS

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	33.025072	OH

General Provider Information

NPI Number	:	1730891441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KYLE ANDREW CARTHENS

Provider Business Mailing Address
First Line	:	944 SELWYN RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44112-2346
Country	:	US
Telephone Number	:	216-210-7959
Fax Number	:

Provider Business Practice Location Address
First Line	:	944 SELWYN RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44112-2346
Country	:	US
Telephone Number	:	216-210-7959
Fax Number	:

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

Provider Enumeration Date	:	12/14/2022
Last Update Date	:	12/14/2022

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Directions to “ MR. KYLE ANDREW CARTHENS ” Practice Location

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