MEDICARE: CAMIKA WORTHAM LMT

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	33.027127	OH

General Provider Information

NPI Number	:	1538986500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAMIKA WORTHAM LMT

Provider Business Mailing Address
First Line	:	4737 SHINNECOCK HLS
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-8228
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4737 SHINNECOCK HLS
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-8228
Country	:	US
Telephone Number	:	708-571-5056
Fax Number	:

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

Provider Enumeration Date	:	09/23/2024
Last Update Date	:	05/02/2025

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Directions to “ CAMIKA WORTHAM LMT” Practice Location

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