MEDICARE: EMILY FRANCINE TSOURMAS 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
1	225700000X	Massage Therapist	17815	OR
2	225700000X	Massage Therapist	116710	TX

General Provider Information

NPI Number	:	1649544495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY FRANCINE TSOURMAS LMT

Provider Business Mailing Address
First Line	:	1619 W 6TH ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78703-5059
Country	:	US
Telephone Number	:	512-657-4504
Fax Number	:

Provider Business Practice Location Address
First Line	:	1619 W 6TH ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78703-5059
Country	:	US
Telephone Number	:	512-657-4504
Fax Number	:

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

Provider Enumeration Date	:	02/25/2012
Last Update Date	:	04/05/2013

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Directions to “ EMILY FRANCINE TSOURMAS LMT” Practice Location

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