MEDICARE: LORRAINE SANDERSTEIN MT

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	MT026476	TX

General Provider Information

NPI Number	:	1790554384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORRAINE SANDERSTEIN MT

Provider Business Mailing Address
First Line	:	5326 VISTA RUN DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-4620
Country	:	US
Telephone Number	:	210-646-2583
Fax Number	:

Provider Business Practice Location Address
First Line	:	5326 VISTA RUN DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-4620
Country	:	US
Telephone Number	:	210-952-5016
Fax Number	:

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

Provider Enumeration Date	:	12/25/2023
Last Update Date	:	01/16/2024

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Directions to “ LORRAINE SANDERSTEIN MT” Practice Location

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