MEDICARE: MS. KAY L WARREN LMBT

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	6258	NC

General Provider Information

NPI Number	:	1265560940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAY L WARREN LMBT

Provider Business Mailing Address
First Line	:	627 FIELDALE PL
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-1321
Country	:	US
Telephone Number	:	336-882-8572
Fax Number	:	336-882-8572

Provider Business Practice Location Address
First Line	:	627 FIELDALE PL
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-1321
Country	:	US
Telephone Number	:	336-882-8572
Fax Number	:	336-882-8572

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

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	07/08/2007

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