MEDICARE: MS. LORISSA ANNE MEYER 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	33.011659-S	OH

General Provider Information

NPI Number	:	1780020719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LORISSA ANNE MEYER LMT

Provider Business Mailing Address
First Line	:	311 E MARKET ST
Second Line	:	3RD FLOOR
City	:	LIMA
State	:	OH
Zip	:	45801-4535
Country	:	US
Telephone Number	:	419-523-9580
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 E MARKET ST
Second Line	:	3RD FLOOR
City	:	LIMA
State	:	OH
Zip	:	45801-4535
Country	:	US
Telephone Number	:	419-523-9580
Fax Number	:

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

Provider Enumeration Date	:	05/16/2013
Last Update Date	:	05/16/2013

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