MEDICARE: MS. MONEE IOLA PIERRE

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	0019009823	VA

General Provider Information

NPI Number	:	1811318207
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MONEE IOLA PIERRE

Provider Business Mailing Address
First Line	:	3979 COLONIAL TRL E
Second Line	:
City	:	SURRY
State	:	VA
Zip	:	23883-2313
Country	:	US
Telephone Number	:	757-814-8600
Fax Number	:

Provider Business Practice Location Address
First Line	:	3979 COLONIAL TRL E
Second Line	:
City	:	SURRY
State	:	VA
Zip	:	23883-2313
Country	:	US
Telephone Number	:	757-814-8600
Fax Number	:

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

Provider Enumeration Date	:	01/02/2014
Last Update Date	:	01/02/2014

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