MEDICARE: KATHRYN LAFLAMME 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	6012	AR

General Provider Information

NPI Number	:	1558509737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN LAFLAMME LMT

Provider Business Mailing Address
First Line	:	3412 HOUSTON ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-5948
Country	:	US
Telephone Number	:	479-628-2289
Fax Number	:	800-882-3906

Provider Business Practice Location Address
First Line	:	3412 HOUSTON ST
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-5948
Country	:	US
Telephone Number	:	479-629-2290
Fax Number	:	800-882-3906

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

Provider Enumeration Date	:	01/27/2009
Last Update Date	:	01/27/2009

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