MEDICARE: MRS. CHRISTINIA LEMONS LMT-BC

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	MT008908	GA

General Provider Information

NPI Number	:	1104314764
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINIA LEMONS LMT-BC

Provider Business Mailing Address
First Line	:	238 LEE ROAD 2086
Second Line	:
City	:	SALEM
State	:	AL
Zip	:	36874-2740
Country	:	US
Telephone Number	:	706-289-0068
Fax Number	:

Provider Business Practice Location Address
First Line	:	1315 DELAUNEY AVE STE 100
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31901-3839
Country	:	US
Telephone Number	:	706-289-0068
Fax Number	:

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

Provider Enumeration Date	:	04/28/2018
Last Update Date	:	04/28/2018

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