MEDICARE: MRS. THERESA ELIZABETH FALLON 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	5804	NM
2	225700000X	Massage Therapist	M06378	MD

General Provider Information

NPI Number	:	1356668651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. THERESA ELIZABETH FALLON LMT

Provider Business Mailing Address
First Line	:	10703 RUM SPRING RD
Second Line	:
City	:	MYERSVILLE
State	:	MD
Zip	:	21773
Country	:	US
Telephone Number	:	802-598-1055
Fax Number	:

Provider Business Practice Location Address
First Line	:	603B WEST PATRICK ST.
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21701
Country	:	US
Telephone Number	:	301-620-1414
Fax Number	:

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

Provider Enumeration Date	:	04/26/2010
Last Update Date	:	02/09/2026

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