MEDICARE: JEANETTA JOSEPH 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	MT0595	DC

General Provider Information

NPI Number	:	1770414211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANETTA JOSEPH LMT

Provider Business Mailing Address
First Line	:	3510 METZEROTT RD
Second Line	:
City	:	COLLEGE PARK
State	:	MD
Zip	:	20740-4436
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1108 K ST NW FL 2
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20005-4094
Country	:	US
Telephone Number	:	202-972-8004
Fax Number	:

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

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ JEANETTA JOSEPH LMT” Practice Location

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