MEDICARE: CALM MASSAGE & BODYWORK

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

General Provider Information

NPI Number	:	1346014073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALM MASSAGE & BODYWORK

Provider Business Mailing Address
First Line	:	395 S REVERE CV APT 101
Second Line	:
City	:	FORT MILL
State	:	SC
Zip	:	29708-8697
Country	:	US
Telephone Number	:	757-672-2007
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 BW THOMAS DR STE 113
Second Line	:
City	:	TEGA CAY
State	:	SC
Zip	:	29708-7240
Country	:	US
Telephone Number	:	803-320-6134
Fax Number	:

Authorized Official
Title or Position	:	OWNER, MASSAGE THERAPIST
Name	:	MONICA MORRIS
Credential	:	LMT
Telephone Number	:	803-320-6134

Provider Enumeration Date	:	11/13/2023
Last Update Date	:	11/13/2023

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