MEDICARE: MRS. REBECCA ELAINE SUMNER LMT, MMP

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	108887	KY

General Provider Information

NPI Number	:	1508107723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. REBECCA ELAINE SUMNER LMT, MMP

Provider Business Mailing Address
First Line	:	909 W 9TH ST STE A
Second Line	:
City	:	RUSSELLVILLE
State	:	KY
Zip	:	42276-9764
Country	:	US
Telephone Number	:	270-893-8706
Fax Number	:

Provider Business Practice Location Address
First Line	:	909 W 9TH ST STE A
Second Line	:
City	:	RUSSELLVILLE
State	:	KY
Zip	:	42276-9764
Country	:	US
Telephone Number	:	270-893-8706
Fax Number	:

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

Provider Enumeration Date	:	03/13/2013
Last Update Date	:	09/15/2025

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