MEDICARE: RUTH-ANN GRANT 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	MA93027	FL

General Provider Information

NPI Number	:	1427620608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH-ANN GRANT LMT

Provider Business Mailing Address
First Line	:	3874 CALIBRE BEND LN APT 912
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-8669
Country	:	US
Telephone Number	:	407-761-1858
Fax Number	:

Provider Business Practice Location Address
First Line	:	3874 CALIBRE BEND LN APT 912
Second Line	:
City	:	WINTER PARK
State	:	FL
Zip	:	32792-8669
Country	:	US
Telephone Number	:	407-761-1858
Fax Number	:

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

Provider Enumeration Date	:	07/15/2021
Last Update Date	:	07/15/2021

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Directions to “ RUTH-ANN GRANT LMT” Practice Location

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