MEDICARE: STEFANIA PERKINSON 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	33.019391	OH

General Provider Information

NPI Number	:	1245881226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFANIA PERKINSON LMT

Provider Business Mailing Address
First Line	:	11002 DETROIT AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-2413
Country	:	US
Telephone Number	:	216-227-8668
Fax Number	:	888-420-0239

Provider Business Practice Location Address
First Line	:	11002 DETROIT AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44102-2413
Country	:	US
Telephone Number	:	216-227-8668
Fax Number	:	888-420-0239

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

Provider Enumeration Date	:	09/22/2019
Last Update Date	:	09/22/2019

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