MEDICARE: MRS. CLAUDIA MAE SUMMERS LMBT

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	8796	NC

General Provider Information

NPI Number	:	1629375076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CLAUDIA MAE SUMMERS LMBT

Provider Business Mailing Address
First Line	:	119 W UNION ST
Second Line	:
City	:	MORGANTON
State	:	NC
Zip	:	28655-3459
Country	:	US
Telephone Number	:	828-413-1766
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 W UNION ST
Second Line	:
City	:	MORGANTON
State	:	NC
Zip	:	28655-3459
Country	:	US
Telephone Number	:	828-413-1766
Fax Number	:

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

Provider Enumeration Date	:	02/22/2011
Last Update Date	:	02/22/2011

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