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NPI Code Detail

MEDICARE: MARCIA GRAY LMT

MEDICARE:   MARCIA  GRAY  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
1225700000XMassage Therapist33.017131OH

General Provider Information

NPI Number : 1811302235
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCIA GRAY LMT
Provider Business Mailing Address
First Line : 23131 EMERY RD
Second Line :
City : WARRENSVILLE HEIGHTS
State : OH
Zip : 44128-5136
Country : US
Telephone Number : 216-514-9590
Fax Number :
Provider Business Practice Location Address
First Line : 23131 EMERY RD
Second Line :
City : WARRENSVILLE HEIGHTS
State : OH
Zip : 44128-5136
Country : US
Telephone Number : 216-514-9590
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2014
Last Update Date : 06/24/2014

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Directions to “ MARCIA GRAY LMT” Practice Location

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