MEDICARE: HAMRAWIT TSEGAYE CMT

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	172M00000X	Mechanotherapist	MT003241	GA

General Provider Information

NPI Number	:	1124345475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAMRAWIT TSEGAYE CMT

Provider Business Mailing Address
First Line	:	2509 PIERCE CIR
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-5768
Country	:	US
Telephone Number	:	770-912-1204
Fax Number	:

Provider Business Practice Location Address
First Line	:	4880 LAWRENCEVILLE HWY
Second Line	:	SUITE 13
City	:	TUCKER
State	:	GA
Zip	:	30084-2938
Country	:	US
Telephone Number	:	770-912-1204
Fax Number	:

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

Provider Enumeration Date	:	04/27/2010
Last Update Date	:	04/27/2010

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Directions to “ HAMRAWIT TSEGAYE CMT” Practice Location

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