MEDICARE: STEPHANIE M DIXON 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	MT-08983	AZ

General Provider Information

NPI Number	:	1306403506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE M DIXON LMT

Provider Business Mailing Address
First Line	:	2550 N STEWART AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-2425
Country	:	US
Telephone Number	:	520-548-5379
Fax Number	:

Provider Business Practice Location Address
First Line	:	5431 N ORACLE RD STE 104A
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-0012
Country	:	US
Telephone Number	:	520-548-5379
Fax Number	:

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

Provider Enumeration Date	:	05/22/2019
Last Update Date	:	05/22/2019

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Directions to “ STEPHANIE M DIXON LMT” Practice Location

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