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NPI Code Detail

MEDICARE: EMILY GIERUT L.M.T

MEDICARE:   EMILY  GIERUT  L.M.T
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 Therapist227.015907IL

General Provider Information

NPI Number : 1740775766
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY GIERUT L.M.T
Provider Business Mailing Address
First Line : 3112 W LORIENT DR
Second Line :
City : MCHENRY
State : IL
Zip : 60050-6102
Country : US
Telephone Number : 815-206-9248
Fax Number :
Provider Business Practice Location Address
First Line : 314 W ROLLINS RD STE B
Second Line :
City : ROUND LAKE BEACH
State : IL
Zip : 60073-1204
Country : US
Telephone Number : 847-546-4220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2018
Last Update Date : 06/22/2018

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Directions to “ EMILY GIERUT L.M.T” Practice Location

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