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NPI Code Detail

MEDICARE: MUNEERAH LISON AUSTIN

MEDICARE: MUNEERAH LISON AUSTIN
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
1225700000XMassage Therapist09611NC

General Provider Information

NPI Number : 1710286406
Entity Type Code : Individual
Provider Name (Legal Business Name) : MUNEERAH LISON AUSTIN
Provider Business Mailing Address
First Line : 910 CRYSTAL BLUFF LN APT 103
Second Line :
City : RALEIGH
State : NC
Zip : 27601-2777
Country : US
Telephone Number : 919-986-7000
Fax Number :
Provider Business Practice Location Address
First Line : 910 CRYSTAL BLUFF LN APT 103
Second Line :
City : RALEIGH
State : NC
Zip : 27601-2777
Country : US
Telephone Number : 919-986-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2011
Last Update Date : 03/21/2011

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Directions to “ MUNEERAH LISON AUSTIN ” Practice Location

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