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NPI Code Detail

MEDICARE: ILIA STRANKO LMT

MEDICARE: ILIA STRANKO 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
1225700000XMassage TherapistMSG009076PA

General Provider Information

NPI Number : 1386021343
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILIA STRANKO LMT
Provider Business Mailing Address
First Line : 2407 BAINBRIDGE STREET
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19146
Country : US
Telephone Number : 860-538-2927
Fax Number :
Provider Business Practice Location Address
First Line : 2308 GRAYS FERRY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19146-1177
Country : US
Telephone Number : 215-772-1040
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2015
Last Update Date : 04/29/2015

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Directions to “ ILIA STRANKO LMT” Practice Location

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