MEDICARE: BETH ANNE WILKINS 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	33.010333	OH

General Provider Information

NPI Number	:	1467231340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH ANNE WILKINS LMT

Provider Business Mailing Address
First Line	:	21325 BRADNER RD
Second Line	:
City	:	LUCKEY
State	:	OH
Zip	:	43443-9729
Country	:	US
Telephone Number	:	419-360-6378
Fax Number	:

Provider Business Practice Location Address
First Line	:	3130 CENTRAL PARK DR W STE A
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43617-1088
Country	:	US
Telephone Number	:	419-841-9622
Fax Number	:

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

Provider Enumeration Date	:	09/28/2023
Last Update Date	:	09/28/2023

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