MEDICARE: MS. TINA MARIE PRICE 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	010716	OH

General Provider Information

NPI Number	:	1427267467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TINA MARIE PRICE LMT

Provider Business Mailing Address
First Line	:	1736 10TH ST
Second Line	:
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44221-4512
Country	:	US
Telephone Number	:	330-926-0699
Fax Number	:

Provider Business Practice Location Address
First Line	:	2034 SCHILLER AVE
Second Line	:
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44223-1783
Country	:	US
Telephone Number	:	330-929-4745
Fax Number	:

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

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/08/2007

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