MEDICARE: HARLEY JAGGI

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	MSG008915	PA

General Provider Information

NPI Number	:	1023466596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARLEY JAGGI

Provider Business Mailing Address
First Line	:	120 W ALLEGHENY RD STE 2
Second Line	:
City	:	IMPERIAL
State	:	PA
Zip	:	15126-9788
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 W ALLEGHENY RD STE 2
Second Line	:
City	:	IMPERIAL
State	:	PA
Zip	:	15126-9788
Country	:	US
Telephone Number	:	724-695-5300
Fax Number	:

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

Provider Enumeration Date	:	05/25/2016
Last Update Date	:	05/25/2016

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Directions to “ HARLEY JAGGI ” Practice Location

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