MEDICARE: LORI BURNS LMT, CMLDT

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	MT.0026069	CO

General Provider Information

NPI Number	:	1427881390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI BURNS LMT, CMLDT

Provider Business Mailing Address
First Line	:	950 KERRY ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82609-2415
Country	:	US
Telephone Number	:	307-262-6426
Fax Number	:

Provider Business Practice Location Address
First Line	:	1977 E A ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-2224
Country	:	US
Telephone Number	:	307-463-1161
Fax Number	:

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

Provider Enumeration Date	:	08/24/2024
Last Update Date	:	08/24/2024

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