MEDICARE: CINDY ANN MANISCALCO RMT

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	608798-11	CO

General Provider Information

NPI Number	:	1467711598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY ANN MANISCALCO RMT

Provider Business Mailing Address
First Line	:	7010 BURROBACK CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80911-2904
Country	:	US
Telephone Number	:	719-641-9562
Fax Number	:

Provider Business Practice Location Address
First Line	:	1009 W COLORADO AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-4327
Country	:	US
Telephone Number	:	719-641-9562
Fax Number	:

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

Provider Enumeration Date	:	05/09/2012
Last Update Date	:	05/15/2012

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