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NPI Code Detail

MEDICARE: ANGIE HAHN LMT

MEDICARE: ANGIE HAHN 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
1225700000XMassage TherapistMAS1126SC

General Provider Information

NPI Number : 1619228467
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGIE HAHN LMT
Provider Business Mailing Address
First Line : 4810 N KINGS HWY
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-2558
Country : US
Telephone Number : 843-448-3390
Fax Number : 843-692-9245
Provider Business Practice Location Address
First Line : 4810 N KINGS HWY
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29577-2558
Country : US
Telephone Number : 843-448-3390
Fax Number : 843-692-9245
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2012
Last Update Date : 09/19/2012

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Directions to “ ANGIE HAHN LMT” Practice Location

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