MEDICARE: MS. JILL GINIGER 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	174400000X	Specialist	MA31491	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MA31491	OTHER	FL	LICENSED MASSAGE THERAPIS

General Provider Information

NPI Number	:	1811028392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JILL GINIGER LMT

Provider Business Mailing Address
First Line	:	5924 THOMAS DRIVE
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32408-5612
Country	:	US
Telephone Number	:	850-234-6563
Fax Number	:	850-235-6955

Provider Business Practice Location Address
First Line	:	5924 THOMAS DR
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32408-5612
Country	:	US
Telephone Number	:	850-234-6563
Fax Number	:	850-235-6955

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

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/08/2007

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