MEDICARE: CINDY L PIERCE DEM, NCTMB

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	6177	NM

General Provider Information

NPI Number	:	1750616173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY L PIERCE DEM, NCTMB

Provider Business Mailing Address
First Line	:	109 E MAIN ST
Second Line	:
City	:	FLUSHING
State	:	MI
Zip	:	48433-2023
Country	:	US
Telephone Number	:	810-487-1212
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 E MAIN ST
Second Line	:
City	:	FLUSHING
State	:	MI
Zip	:	48433-2023
Country	:	US
Telephone Number	:	810-487-1212
Fax Number	:

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

Provider Enumeration Date	:	10/04/2009
Last Update Date	:	10/04/2009

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