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NPI Code Detail

MEDICARE: MRS. MARY TERESA ROSARIO LMT

MEDICARE:  MRS. MARY TERESA ROSARIO  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
1225700000XMassage Therapist2024010673MO

General Provider Information

NPI Number : 1285484808
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY TERESA ROSARIO LMT
Provider Business Mailing Address
First Line : 2919 STATE ROAD AA
Second Line :
City : HOLTS SUMMIT
State : MO
Zip : 65043-1208
Country : US
Telephone Number : 609-680-1416
Fax Number :
Provider Business Practice Location Address
First Line : 2409 HYDE PARK RD
Second Line :
City : JEFFERSON CITY
State : MO
Zip : 65109-4732
Country : US
Telephone Number : 609-680-1416
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2024
Last Update Date : 03/26/2024

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Directions to “ MRS. MARY TERESA ROSARIO LMT” Practice Location

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