MEDICARE: MR. RICHARD CHARLES RALLS L.M.P.

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	173C00000X	Reflexologist	MA60048256	WA

General Provider Information

NPI Number	:	1861632887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD CHARLES RALLS L.M.P.

Provider Business Mailing Address
First Line	:	1612 W DEAN AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-1825
Country	:	US
Telephone Number	:	509-209-0689
Fax Number	:

Provider Business Practice Location Address
First Line	:	1612 W DEAN AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-1825
Country	:	US
Telephone Number	:	509-209-0689
Fax Number	:

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

Provider Enumeration Date	:	03/03/2009
Last Update Date	:	03/03/2009

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