MEDICARE: MR. MICHAEL LANE CASCIERE PT, MS

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	225100000X	Physical Therapist	2305203776	VA
2	225100000X	Physical Therapist	1212	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	650016635	OTHER	NC	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1649360686	OTHER	VA	ANTHEM
2	4862886	OTHER	NC	AETNA
3	0787K	OTHER	NC	BCBS NC

General Provider Information

NPI Number	:	1518920263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL LANE CASCIERE PT, MS

Provider Business Mailing Address
First Line	:	1915 LENDEW ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27408-7033
Country	:	US
Telephone Number	:	336-275-7405
Fax Number	:	336-275-3320

Provider Business Practice Location Address
First Line	:	1915 LENDEW ST
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27408-7033
Country	:	US
Telephone Number	:	336-275-7405
Fax Number	:	336-275-3320

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	09/13/2015

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