MEDICARE: JAMES DEVINNEY

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	MSG002899	PA

General Provider Information

NPI Number	:	1619488582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES DEVINNEY

Provider Business Mailing Address
First Line	:	628 N GALLATIN AVENUE EXT
Second Line	:
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-6400
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	628 N GALLATIN AVENUE EXT
Second Line	:
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-6400
Country	:	US
Telephone Number	:	724-570-6162
Fax Number	:

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

Provider Enumeration Date	:	10/19/2017
Last Update Date	:	10/19/2017

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