MEDICARE: MS. ANNA MALENA HART 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	MAS-3178	ID
2	225700000X	Massage Therapist	14521	TN

General Provider Information

NPI Number	:	1720545510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANNA MALENA HART LMT

Provider Business Mailing Address
First Line	:	221 S SEMINOLE DR
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37411-4126
Country	:	US
Telephone Number	:	423-305-8337
Fax Number	:

Provider Business Practice Location Address
First Line	:	13 W KENT ST STE 102
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37405-9913
Country	:	US
Telephone Number	:	423-305-8337
Fax Number	:

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

Provider Enumeration Date	:	02/27/2019
Last Update Date	:	12/07/2023

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Directions to “ MS. ANNA MALENA HART LMT” Practice Location

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