MEDICARE: JENNIFER LYNN EARHART 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	33.017902	OH

General Provider Information

NPI Number	:	1982557344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LYNN EARHART LMT

Provider Business Mailing Address
First Line	:	4452 W 69TH PL
Second Line	:
City	:	BROOKLYN
State	:	OH
Zip	:	44144-2820
Country	:	US
Telephone Number	:	216-271-1133
Fax Number	:	216-271-1325

Provider Business Practice Location Address
First Line	:	6829 BROADWAY AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-1313
Country	:	US
Telephone Number	:	216-271-1133
Fax Number	:	216-271-1325

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

Provider Enumeration Date	:	02/17/2026
Last Update Date	:	02/17/2026

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