MEDICARE: MS. MELANIE SUE RASILE 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

General Provider Information

NPI Number	:	1811601438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELANIE SUE RASILE LMT

Provider Business Mailing Address
First Line	:	25000 EUCLID AVE STE 302
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44117-2646
Country	:	US
Telephone Number	:	216-731-9215
Fax Number	:	216-731-5456

Provider Business Practice Location Address
First Line	:	25000 EUCLID AVE STE 302
Second Line	:
City	:	EUCLID
State	:	OH
Zip	:	44117-2646
Country	:	US
Telephone Number	:	216-731-9215
Fax Number	:	216-731-5456

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

Provider Enumeration Date	:	01/09/2023
Last Update Date	:	01/09/2023

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