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NPI Code Detail

MEDICARE: AMANDA VACHARAT

MEDICARE:   AMANDA  VACHARAT
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
1225700000XMassage TherapistMSG008431PA

General Provider Information

NPI Number : 1457754723
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA VACHARAT
Provider Business Mailing Address
First Line : 1413 ACADEMY LN
Second Line :
City : ELKINS PARK
State : PA
Zip : 19027-2514
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1413 ACADEMY LN
Second Line :
City : ELKINS PARK
State : PA
Zip : 19027-2514
Country : US
Telephone Number : 267-241-7501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2014
Last Update Date : 10/01/2014

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Directions to “ AMANDA VACHARAT ” Practice Location

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