MEDICARE: MRS. YULAY E CASEY MASSAGE THERAPIST

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	11080	NV

General Provider Information

NPI Number	:	1497416473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. YULAY E CASEY MASSAGE THERAPIST

Provider Business Mailing Address
First Line	:	9897 PANTHER HOLLOW ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-8723
Country	:	US
Telephone Number	:	347-499-0779
Fax Number	:

Provider Business Practice Location Address
First Line	:	6539 LAS VEGAS BLVD S
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-3222
Country	:	US
Telephone Number	:	347-499-0779
Fax Number	:

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

Provider Enumeration Date	:	01/03/2022
Last Update Date	:	01/03/2022

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