MEDICARE: KIMBERLY SANTOS

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	MSG003168	PA

General Provider Information

NPI Number	:	1629720743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY SANTOS

Provider Business Mailing Address
First Line	:	2217 FOX RUN
Second Line	:
City	:	EASTON
State	:	PA
Zip	:	18042-5373
Country	:	US
Telephone Number	:	610-442-0944
Fax Number	:

Provider Business Practice Location Address
First Line	:	44 E BROAD ST STE 15
Second Line	:
City	:	BETHLEHEM
State	:	PA
Zip	:	18018-5920
Country	:	US
Telephone Number	:	610-442-0944
Fax Number	:

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

Provider Enumeration Date	:	01/20/2022
Last Update Date	:	01/20/2022

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Directions to “ KIMBERLY SANTOS ” Practice Location

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