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NPI Code Detail

MEDICARE: MS. RHONDA KAY BOOLEN L.M.T.

MEDICARE: MS. RHONDA KAY BOOLEN L.M.T.
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 Therapist004888OH

General Provider Information

NPI Number : 1477895746
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RHONDA KAY BOOLEN L.M.T.
Provider Business Mailing Address
First Line : 6822 WHIPPLE AVE NW
Second Line :
City : NORTH CANTON
State : OH
Zip : 44720-7336
Country : US
Telephone Number : 330-493-6496
Fax Number :
Provider Business Practice Location Address
First Line : 6822 WHIPPLE AVE NW
Second Line :
City : NORTH CANTON
State : OH
Zip : 44720-7336
Country : US
Telephone Number : 330-493-6496
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2013
Last Update Date : 03/25/2013

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