MEDICARE: CARRIE SHALEY 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	MSG007904	PA

General Provider Information

NPI Number	:	1447605050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARRIE SHALEY LMT

Provider Business Mailing Address
First Line	:	2882 W LIBERTY AVE FL 2
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-2622
Country	:	US
Telephone Number	:	412-999-4612
Fax Number	:

Provider Business Practice Location Address
First Line	:	2882 W LIBERTY AVE FL 2
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-2622
Country	:	US
Telephone Number	:	412-999-4612
Fax Number	:

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

Provider Enumeration Date	:	05/02/2016
Last Update Date	:	04/22/2021

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Directions to “ CARRIE SHALEY LMT” Practice Location

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