MEDICARE: TIYA OMOSIGHO 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	33.023416	OH
2	376K00000X	Nurse's Aide	401651010514	OH

General Provider Information

NPI Number	:	1447957378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIYA OMOSIGHO LMT

Provider Business Mailing Address
First Line	:	3244 HENDERSON RD STE 3
Second Line	:
City	:	UPPER ARLINGTON
State	:	OH
Zip	:	43220-7300
Country	:	US
Telephone Number	:	704-326-1449
Fax Number	:

Provider Business Practice Location Address
First Line	:	3244 HENDERSON RD STE 3
Second Line	:
City	:	UPPER ARLINGTON
State	:	OH
Zip	:	43220-7300
Country	:	US
Telephone Number	:	704-326-1449
Fax Number	:

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

Provider Enumeration Date	:	02/10/2023
Last Update Date	:	04/10/2026

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Directions to “ TIYA OMOSIGHO LMT” Practice Location

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