MEDICARE: MELISSA A ECKMAN 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	019756	NY

General Provider Information

NPI Number	:	1841464880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA A ECKMAN LMT

Provider Business Mailing Address
First Line	:	1597 RIDGE RD W
Second Line	:	SUITE 101E
City	:	ROCHESTER
State	:	NY
Zip	:	14615-2513
Country	:	US
Telephone Number	:	585-576-0941
Fax Number	:

Provider Business Practice Location Address
First Line	:	1597 RIDGE RD W
Second Line	:	SUITE 101E
City	:	ROCHESTER
State	:	NY
Zip	:	14615-2513
Country	:	US
Telephone Number	:	585-576-0941
Fax Number	:

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

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	04/22/2008

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