MEDICARE: MISS SHARON PATRICE SHOCH NCMT

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	0019000864	VA
2	225700000X	Massage Therapist	MA58341	FL

General Provider Information

NPI Number	:	1356424402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SHARON PATRICE SHOCH NCMT

Provider Business Mailing Address
First Line	:	3264 W PRICE BLVD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-4986
Country	:	US
Telephone Number	:	941-467-2960
Fax Number	:

Provider Business Practice Location Address
First Line	:	3264 W PRICE BLVD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34286-4986
Country	:	US
Telephone Number	:	941-525-4535
Fax Number	:

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	08/22/2011

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