MEDICARE: MRS. CATHERINE MICHELLE RHOADS L.M.T.

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	013232-01	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	109845GG	OTHER	NY	PREFERRED CARE

General Provider Information

NPI Number	:	1831150978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATHERINE MICHELLE RHOADS L.M.T.

Provider Business Mailing Address
First Line	:	18 HILLTOP DR
Second Line	:
City	:	LE ROY
State	:	NY
Zip	:	14482-1420
Country	:	US
Telephone Number	:	585-749-6915
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 LAKE AVE
Second Line	:
City	:	HILTON
State	:	NY
Zip	:	14468-1198
Country	:	US
Telephone Number	:	585-392-4100
Fax Number	:

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

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	07/08/2007

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