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NPI Code Detail

MEDICARE: KARIN CIVELLO LMT

MEDICARE:   KARIN  CIVELLO  LMT
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
1225700000XMassage TherapistLA3470LA

General Provider Information

NPI Number : 1215295571
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARIN CIVELLO LMT
Provider Business Mailing Address
First Line : 817 ROSEDALE DR
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70124-1739
Country : US
Telephone Number : 504-488-7554
Fax Number : 504-828-3297
Provider Business Practice Location Address
First Line : 817 ROSEDALE DR
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70124-1739
Country : US
Telephone Number : 504-488-7554
Fax Number : 504-828-3297
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2012
Last Update Date : 04/24/2012

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Directions to “ KARIN CIVELLO LMT” Practice Location

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