MEDICARE: KARLA MCDERMOTT 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	33.026902	OH

General Provider Information

NPI Number	:	1306722533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA MCDERMOTT LMT

Provider Business Mailing Address
First Line	:	5380 DOVETREE BLVD APT 18
Second Line	:
City	:	MORAINE
State	:	OH
Zip	:	45439-5179
Country	:	US
Telephone Number	:	937-671-6016
Fax Number	:

Provider Business Practice Location Address
First Line	:	131 S MAIN ST
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45458-2370
Country	:	US
Telephone Number	:	937-938-9500
Fax Number	:

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

Provider Enumeration Date	:	08/13/2025
Last Update Date	:	08/13/2025

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Directions to “ KARLA MCDERMOTT LMT” Practice Location

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