MEDICARE: LYNNE KASAL C.M.T.

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	49783	CA

General Provider Information

NPI Number	:	1194148957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNE KASAL C.M.T.

Provider Business Mailing Address
First Line	:	2297 E ALEJO RD
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-6207
Country	:	US
Telephone Number	:	760-219-0958
Fax Number	:

Provider Business Practice Location Address
First Line	:	2225 E TAHQUITZ CANYON WAY STE 6
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92262-7022
Country	:	US
Telephone Number	:	760-219-0958
Fax Number	:

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

Provider Enumeration Date	:	01/30/2014
Last Update Date	:	01/30/2014

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