MEDICARE: YOLANDA CRUZ 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	33.022978	OH

General Provider Information

NPI Number	:	1801348289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOLANDA CRUZ LMT

Provider Business Mailing Address
First Line	:	3988 W 23RD ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44109-2908
Country	:	US
Telephone Number	:	216-409-8348
Fax Number	:

Provider Business Practice Location Address
First Line	:	6731 RIDGE RD
Second Line	:	106
City	:	PARMA
State	:	OH
Zip	:	44129-5708
Country	:	US
Telephone Number	:	216-409-8348
Fax Number	:

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

Provider Enumeration Date	:	11/01/2016
Last Update Date	:	11/01/2016

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