MEDICARE: DIANE MCKOWN

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	MSG002559	PA

General Provider Information

NPI Number	:	1669965406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE MCKOWN

Provider Business Mailing Address
First Line	:	1068 MCALLISTER DR
Second Line	:
City	:	NEW KENSINGTON
State	:	PA
Zip	:	15068-9214
Country	:	US
Telephone Number	:	412-608-3285
Fax Number	:

Provider Business Practice Location Address
First Line	:	1068 MCALLISTER DR
Second Line	:
City	:	NEW KENSINGTON
State	:	PA
Zip	:	15068-9214
Country	:	US
Telephone Number	:	412-608-3285
Fax Number	:

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

Provider Enumeration Date	:	06/06/2018
Last Update Date	:	06/06/2018

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Directions to “ DIANE MCKOWN ” Practice Location

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