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NPI Code Detail

MEDICARE: TANIKA SMITH LMT

MEDICARE: TANIKA SMITH 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
1163WM1400XNurse Massage Therapist (NMT)MT-27152AZ

General Provider Information

NPI Number : 1760076160
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANIKA SMITH LMT
Provider Business Mailing Address
First Line : 10 E BELL RD APT 1006
Second Line :
City : PHOENIX
State : AZ
Zip : 85022-6302
Country : US
Telephone Number : 317-366-3419
Fax Number :
Provider Business Practice Location Address
First Line : 10 E BELL RD APT 1006
Second Line :
City : PHOENIX
State : AZ
Zip : 85022-6302
Country : US
Telephone Number : 317-366-3419
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2021
Last Update Date : 02/25/2021

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