MEDICARE: MS. JEAN MARIE HELFMAN LCMT

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	:	1629302070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JEAN MARIE HELFMAN LCMT

Provider Business Mailing Address
First Line	:	2645 78TH ST E
Second Line	:
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55076-2947
Country	:	US
Telephone Number	:	651-470-0338
Fax Number	:

Provider Business Practice Location Address
First Line	:	1551 LIVINGSTON AVE
Second Line	:	SUITE 104
City	:	WEST SAINT PAUL
State	:	MN
Zip	:	55118-3416
Country	:	US
Telephone Number	:	651-457-6630
Fax Number	:

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

Provider Enumeration Date	:	10/01/2009
Last Update Date	:	10/01/2009

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