MEDICARE: MICHELLE SOLA 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	024330	NY

General Provider Information

NPI Number	:	1568150993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE SOLA LMT

Provider Business Mailing Address
First Line	:	530 E 159TH ST APT 24
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-4641
Country	:	US
Telephone Number	:	929-319-0971
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 E 159TH ST APT 24
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-4641
Country	:	US
Telephone Number	:	929-319-0971
Fax Number	:

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

Provider Enumeration Date	:	04/25/2023
Last Update Date	:	04/25/2023

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Directions to “ MICHELLE SOLA LMT” Practice Location

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