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NPI Code Detail

MEDICARE: MS. CHRISTINE A ROSE LMT

MEDICARE: MS. CHRISTINE A ROSE 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 Therapist9469MA

General Provider Information

NPI Number : 1285977074
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTINE A ROSE LMT
Provider Business Mailing Address
First Line : 56 MALLET ST
Second Line :
City : DORCHESTER
State : MA
Zip : 02124-2625
Country : US
Telephone Number : 617-821-2875
Fax Number :
Provider Business Practice Location Address
First Line : 3464 WASHINGTON ST
Second Line :
City : JAMAICA PLAIN
State : MA
Zip : 02130-2665
Country : US
Telephone Number : 617-821-2875
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2013
Last Update Date : 04/01/2013

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