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NPI Code Detail

MEDICARE: MS. BRIDGET RANDALL KIMSEY LCMT, MMP

MEDICARE:  MS. BRIDGET RANDALL KIMSEY  LCMT, MMP
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
1225700000XMassage Therapist6317MA

General Provider Information

NPI Number : 1841519469
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BRIDGET RANDALL KIMSEY LCMT, MMP
Provider Business Mailing Address
First Line : 17 LEXINGTON GRN
Second Line :
City : SOUTH BURLINGTON
State : VT
Zip : 05403-7015
Country : US
Telephone Number : 802-557-7438
Fax Number :
Provider Business Practice Location Address
First Line : 17 LEXINGTON GRN
Second Line :
City : SOUTH BURLINGTON
State : VT
Zip : 05403-7015
Country : US
Telephone Number : 802-557-7438
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2010
Last Update Date : 05/07/2019

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Directions to “ MS. BRIDGET RANDALL KIMSEY LCMT, MMP” Practice Location

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