MEDICARE: MS. JOY LORRAINE BUCKLEY 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	MA 41284	FL

General Provider Information

NPI Number	:	1841542768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOY LORRAINE BUCKLEY LMT

Provider Business Mailing Address
First Line	:	709 SW 28TH AVE
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-7922
Country	:	US
Telephone Number	:	561-634-1139
Fax Number	:

Provider Business Practice Location Address
First Line	:	3111 W BOYNTON BEACH BLVD
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-4613
Country	:	US
Telephone Number	:	561-742-3283
Fax Number	:

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

Provider Enumeration Date	:	10/03/2012
Last Update Date	:	10/03/2012

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