MEDICARE: CAROL ANN DEINHARDT 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	012225	NY

General Provider Information

NPI Number	:	1861548653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL ANN DEINHARDT LMT

Provider Business Mailing Address
First Line	:	51 COLONIAL RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14609-6735
Country	:	US
Telephone Number	:	585-482-1177
Fax Number	:

Provider Business Practice Location Address
First Line	:	720 EAST AVE
Second Line	:	SUITE 102
City	:	ROCHESTER
State	:	NY
Zip	:	14607-2192
Country	:	US
Telephone Number	:	585-442-1580
Fax Number	:	585-442-3935

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

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	07/08/2007

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Directions to “ CAROL ANN DEINHARDT LMT” Practice Location

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