MEDICARE: SHANELLE DUAH 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	33.025824	OH

General Provider Information

NPI Number	:	1366152860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANELLE DUAH LMT

Provider Business Mailing Address
First Line	:	3324 MERIDIAN RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4039
Country	:	US
Telephone Number	:	626-922-0454
Fax Number	:

Provider Business Practice Location Address
First Line	:	3324 MERIDIAN RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43232-4039
Country	:	US
Telephone Number	:	626-922-0454
Fax Number	:

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

Provider Enumeration Date	:	11/25/2022
Last Update Date	:	03/09/2026

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