MEDICARE: MS. REBECCA CORINNE RIZZUTO ADVANCED MASSAGE PRA

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		CA
2	225700000X	Massage Therapist		MN

General Provider Information

NPI Number	:	1013262278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. REBECCA CORINNE RIZZUTO ADVANCED MASSAGE PRA

Provider Business Mailing Address
First Line	:	3747 MINNEHAHA AVE STE 207
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2858
Country	:	US
Telephone Number	:	415-690-0614
Fax Number	:

Provider Business Practice Location Address
First Line	:	3747 MINNEHAHA AVE STE 207
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2858
Country	:	US
Telephone Number	:	415-690-0614
Fax Number	:

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

Provider Enumeration Date	:	07/13/2012
Last Update Date	:	12/13/2023

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