MEDICARE: HEATHER LYNNE EASTON L.M.T.

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	3591	NE

General Provider Information

NPI Number	:	1851864599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER LYNNE EASTON L.M.T.

Provider Business Mailing Address
First Line	:	3601 CALVERT ST STE 15
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68506-5797
Country	:	US
Telephone Number	:	308-991-4086
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 CALVERT ST STE 15
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68506-5797
Country	:	US
Telephone Number	:	308-991-4086
Fax Number	:

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

Provider Enumeration Date	:	01/04/2019
Last Update Date	:	01/04/2019

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Directions to “ HEATHER LYNNE EASTON L.M.T.” Practice Location

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