MEDICARE: REBECCA JO BRADY-MESSINA 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
1	225700000X	Massage Therapist	021895	OH

General Provider Information

NPI Number	:	1225692254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA JO BRADY-MESSINA LMT

Provider Business Mailing Address
First Line	:	3270 ORDERS RD
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-8833
Country	:	US
Telephone Number	:	614-378-0556
Fax Number	:

Provider Business Practice Location Address
First Line	:	4296 BROADWAY
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-3023
Country	:	US
Telephone Number	:	614-378-0556
Fax Number	:

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

Provider Enumeration Date	:	04/25/2019
Last Update Date	:	04/25/2019

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