MEDICARE: MS. ALEXANDRA JANE HAMER 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	00083	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00083	OTHER	NC	NC BOARD OF MASSAGE AND BODYWORK THERAPY

General Provider Information

NPI Number	:	1285266973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALEXANDRA JANE HAMER LMBT

Provider Business Mailing Address
First Line	:	715 ARNETTE AVE
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27701-3104
Country	:	US
Telephone Number	:	919-682-8102
Fax Number	:

Provider Business Practice Location Address
First Line	:	715 ARNETTE AVE
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27701-3104
Country	:	US
Telephone Number	:	919-682-8102
Fax Number	:

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

Provider Enumeration Date	:	02/10/2020
Last Update Date	:	02/10/2020

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