MEDICARE: ECO CHATEAU

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

General Provider Information

NPI Number	:	1245608017
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECO CHATEAU

Provider Business Mailing Address
First Line	:	2831 CAMINO DEL RIO S STE 209
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3828
Country	:	US
Telephone Number	:	619-795-6955
Fax Number	:

Provider Business Practice Location Address
First Line	:	2831 CAMINO DEL RIO S STE 209
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3828
Country	:	US
Telephone Number	:	619-795-6955
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MISS CHRISTINE MCDANNELL
Credential	:
Telephone Number	:	619-550-1844

Provider Enumeration Date	:	09/09/2015
Last Update Date	:	09/09/2015

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Directions to “ECO CHATEAU ” Practice Location

Language	Start Address	Practice Location

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