MEDICARE: AMANDA TOLISE PARKER 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	4743	TN

General Provider Information

NPI Number	:	1689852311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA TOLISE PARKER LMT

Provider Business Mailing Address
First Line	:	145 ARSENAL DR
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37064-2302
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2416 MUSIC VALLEY DR
Second Line	:	SUITE 119
City	:	NASHVILLE
State	:	TN
Zip	:	37214-1011
Country	:	US
Telephone Number	:	615-294-5233
Fax Number	:

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

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	02/05/2008

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