MEDICARE: RASHELL HECK

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	012523	PA
2	225700000X	Massage Therapist	MSG012523	PA

General Provider Information

NPI Number	:	1154802940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RASHELL HECK

Provider Business Mailing Address
First Line	:	4453 PENN AVE APT 4
Second Line	:
City	:	SINKING SPRING
State	:	PA
Zip	:	19608-8623
Country	:	US
Telephone Number	:	610-301-9661
Fax Number	:

Provider Business Practice Location Address
First Line	:	4453 PENN AVE APT 4
Second Line	:
City	:	SINKING SPRING
State	:	PA
Zip	:	19608-8623
Country	:	US
Telephone Number	:	610-301-9661
Fax Number	:

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

Provider Enumeration Date	:	08/28/2018
Last Update Date	:	08/28/2018

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Directions to “ RASHELL HECK ” Practice Location

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