MEDICARE: DONNA M ANDERSON 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	33.009454	OH

General Provider Information

NPI Number	:	1467119248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA M ANDERSON LMT

Provider Business Mailing Address
First Line	:	4771 GLENDALE MILFORD RD
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242-3819
Country	:	US
Telephone Number	:	513-469-9440
Fax Number	:	513-469-1880

Provider Business Practice Location Address
First Line	:	4771 GLENDALE MILFORD RD
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242-3819
Country	:	US
Telephone Number	:	513-469-9440
Fax Number	:	513-469-1880

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

Provider Enumeration Date	:	11/29/2021
Last Update Date	:	11/29/2021

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Directions to “ DONNA M ANDERSON LMT” Practice Location

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