MEDICARE: TINA MARIE NEWCOMB 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	MSG012160	PA

General Provider Information

NPI Number	:	1669271193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA MARIE NEWCOMB LMT

Provider Business Mailing Address
First Line	:	2100 DENNIS DR
Second Line	:
City	:	READING
State	:	PA
Zip	:	19601-1136
Country	:	US
Telephone Number	:	484-929-0455
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 STEVENS AVE STE B1
Second Line	:
City	:	WEST LAWN
State	:	PA
Zip	:	19609-1425
Country	:	US
Telephone Number	:	484-929-0455
Fax Number	:

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

Provider Enumeration Date	:	03/08/2025
Last Update Date	:	03/08/2025

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Directions to “ TINA MARIE NEWCOMB LMT” Practice Location

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