MEDICARE: MRS. CASSIE RAWCLIFFE 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	02366	RI

General Provider Information

NPI Number	:	1316475577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CASSIE RAWCLIFFE LMT

Provider Business Mailing Address
First Line	:	185 OLD COUNTY RD
Second Line	:
City	:	SMITHFIELD
State	:	RI
Zip	:	02917-2927
Country	:	US
Telephone Number	:	860-942-2364
Fax Number	:

Provider Business Practice Location Address
First Line	:	1481 ATWOOD AVE
Second Line	:
City	:	JOHNSTON
State	:	RI
Zip	:	02919-4800
Country	:	US
Telephone Number	:	401-274-0011
Fax Number	:

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

Provider Enumeration Date	:	05/31/2017
Last Update Date	:	05/31/2017

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