MEDICARE: MS. NANCY JANE BEADLING CFOM, CMT, CLT,COTA/

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	222Z00000X	Orthotist
2	225700000X	Massage Therapist	37578	ME
3	174400000X	Specialist	OA2580	ME
4	174400000X	Specialist	MT714	ME

General Provider Information

NPI Number	:	1235398553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NANCY JANE BEADLING CFOM, CMT, CLT,COTA/

Provider Business Mailing Address
First Line	:	247A LAKEVIEW DR
Second Line	:
City	:	SOUTH CHINA
State	:	ME
Zip	:	04358-5616
Country	:	US
Telephone Number	:	207-624-2997
Fax Number	:

Provider Business Practice Location Address
First Line	:	247A LAKEVIEW DR
Second Line	:
City	:	SOUTH CHINA
State	:	ME
Zip	:	04358-5616
Country	:	US
Telephone Number	:	207-624-2997
Fax Number	:

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

Provider Enumeration Date	:	06/02/2008
Last Update Date	:	04/11/2012

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