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NPI Code Detail

MEDICARE: IVETTE LORETO LMT

MEDICARE: IVETTE LORETO 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 TherapistMT-29532AZ

General Provider Information

NPI Number : 1841029675
Entity Type Code : Individual
Provider Name (Legal Business Name) : IVETTE LORETO LMT
Provider Business Mailing Address
First Line : 312 W 10TH ST STE 2
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85122-3940
Country : US
Telephone Number : 520-222-7385
Fax Number : 866-727-9116
Provider Business Practice Location Address
First Line : 312 W 10TH ST STE 2
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85122-3940
Country : US
Telephone Number : 520-222-7385
Fax Number : 866-727-9116
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2024
Last Update Date : 08/06/2024

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Directions to “ IVETTE LORETO LMT” Practice Location

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