MEDICARE: ESSENTIAL HEALTH AND WELLNESS, LLC

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	:	1376296319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSENTIAL HEALTH AND WELLNESS, LLC

Provider Business Mailing Address
First Line	:	10800 MALLORY DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63123-5949
Country	:	US
Telephone Number	:	314-347-8612
Fax Number	:

Provider Business Practice Location Address
First Line	:	9109 WATSON RD STE 200
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63126-2235
Country	:	US
Telephone Number	:	314-347-8612
Fax Number	:

Authorized Official
Title or Position	:	OWNER AND THERAPIST
Name	:	KATHERINE M LAMPRICH
Credential	:	LMT
Telephone Number	:	314-347-8612

Provider Enumeration Date	:	01/31/2022
Last Update Date	:	02/09/2022

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