MEDICARE: MR. DOUGLAS ROYER 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	33.023219	OH

General Provider Information

NPI Number	:	1649854100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DOUGLAS ROYER LMT

Provider Business Mailing Address
First Line	:	508 W 3RD AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43201-3364
Country	:	US
Telephone Number	:	937-542-9792
Fax Number	:

Provider Business Practice Location Address
First Line	:	508 W 3RD AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43201-3364
Country	:	US
Telephone Number	:	937-542-9792
Fax Number	:

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

Provider Enumeration Date	:	05/11/2021
Last Update Date	:	05/11/2021

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Directions to “ MR. DOUGLAS ROYER LMT” Practice Location

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