MEDICARE: SCOTT PFALZGRAF CMT

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	67063	CA

General Provider Information

NPI Number	:	1508684291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT PFALZGRAF CMT

Provider Business Mailing Address
First Line	:	PO BOX 1071
Second Line	:
City	:	WEST POINT
State	:	CA
Zip	:	95255-1071
Country	:	US
Telephone Number	:	530-863-6207
Fax Number	:

Provider Business Practice Location Address
First Line	:	298 RAIL ROAD FLAT ST.
Second Line	:
City	:	RAIL ROAD FLAT
State	:	CA
Zip	:	95248
Country	:	US
Telephone Number	:	530-863-6207
Fax Number	:

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

Provider Enumeration Date	:	10/01/2024
Last Update Date	:	10/01/2024

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