MEDICARE: MR. RICHARD LEHMAN 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	172M00000X	Mechanotherapist	MA64957	FL

General Provider Information

NPI Number	:	1568856748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD LEHMAN LMT

Provider Business Mailing Address
First Line	:	209 S 2ND ST
Second Line	:	SUITE #1
City	:	FLAGLER BEACH
State	:	FL
Zip	:	32136-6603
Country	:	US
Telephone Number	:	386-693-1363
Fax Number	:

Provider Business Practice Location Address
First Line	:	209 S 2ND ST
Second Line	:	SUITE #1
City	:	FLAGLER BEACH
State	:	FL
Zip	:	32136-6603
Country	:	US
Telephone Number	:	386-693-1363
Fax Number	:

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

Provider Enumeration Date	:	03/25/2015
Last Update Date	:	03/25/2015

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