MEDICARE: SYLVIA CHRISNEY 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

General Provider Information

NPI Number	:	1568008274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYLVIA CHRISNEY CMT

Provider Business Mailing Address
First Line	:	PO BOX 145
Second Line	:
City	:	BAYSIDE
State	:	CA
Zip	:	95524-0145
Country	:	US
Telephone Number	:	510-495-4171
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 G ST
Second Line	:
City	:	ARCATA
State	:	CA
Zip	:	95521-6694
Country	:	US
Telephone Number	:	707-599-2452
Fax Number	:

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

Provider Enumeration Date	:	11/18/2019
Last Update Date	:	11/18/2019

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Directions to “ SYLVIA CHRISNEY CMT” Practice Location

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