MEDICARE: LYMPH BRIGHT

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

General Provider Information

NPI Number	:	1144070293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LYMPH BRIGHT

Provider Business Mailing Address
First Line	:	23272 MILL CREEK DR
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1641
Country	:	US
Telephone Number	:	949-903-0535
Fax Number	:

Provider Business Practice Location Address
First Line	:	23272 MILL CREEK DR
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-1641
Country	:	US
Telephone Number	:	949-903-0535
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	LILIANE ZACCHARIAS
Credential	:
Telephone Number	:	949-903-0535

Provider Enumeration Date	:	03/22/2024
Last Update Date	:	03/22/2024

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