MEDICARE: MS. LEAH M REARICK 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	#3159	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992082754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LEAH M REARICK LMT

Provider Business Mailing Address
First Line	:	17900 JEFFERSON PARK
Second Line	:	STE 101
City	:	MIDDLEBURG HTS.
State	:	OH
Zip	:	44130-3437
Country	:	US
Telephone Number	:	440-891-6299
Fax Number	:	440-891-6899

Provider Business Practice Location Address
First Line	:	17900 JEFFERSON PARK
Second Line	:	STE 101
City	:	MIDDLEBURG HTS.
State	:	OH
Zip	:	44130-3437
Country	:	US
Telephone Number	:	440-891-6299
Fax Number	:	440-891-6899

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

Provider Enumeration Date	:	11/08/2011
Last Update Date	:	11/08/2011

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