MEDICARE: VERED RUTH SEATON LMBT

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	16684	NC

General Provider Information

NPI Number	:	1023751146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERED RUTH SEATON LMBT

Provider Business Mailing Address
First Line	:	1110 WAKE FOREST RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-1354
Country	:	US
Telephone Number	:	602-284-1639
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 WAKE FOREST RD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-1354
Country	:	US
Telephone Number	:	602-284-1639
Fax Number	:

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

Provider Enumeration Date	:	04/16/2022
Last Update Date	:	04/16/2022

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