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NPI Code Detail

MEDICARE: MS. RENEE CHRISTINE SHOTT LMT

MEDICARE:  MS. RENEE CHRISTINE SHOTT  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 Therapist18124OH

General Provider Information

NPI Number : 1861717530
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RENEE CHRISTINE SHOTT LMT
Provider Business Mailing Address
First Line : 14209 KENNERDOWN AVE
Second Line :
City : MAPLE HEIGHTS
State : OH
Zip : 44137-3625
Country : US
Telephone Number : 216-210-3368
Fax Number :
Provider Business Practice Location Address
First Line : 14209 KENNERDOWN AVE
Second Line :
City : MAPLE HEIGHTS
State : OH
Zip : 44137-3625
Country : US
Telephone Number : 216-210-3368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2010
Last Update Date : 04/06/2010

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Directions to “ MS. RENEE CHRISTINE SHOTT LMT” Practice Location

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