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NPI Code Detail

MEDICARE: JOHN REES BODE LMT

MEDICARE: JOHN REES BODE 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 TherapistMT134991TX

General Provider Information

NPI Number : 1871166918
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN REES BODE LMT
Provider Business Mailing Address
First Line : 220 MELBRY RD
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-7946
Country : US
Telephone Number : 337-371-0871
Fax Number :
Provider Business Practice Location Address
First Line : 1901 CHEMIN METAIRIE PKWY STE 2
Second Line :
City : YOUNGSVILLE
State : LA
Zip : 70592-5660
Country : US
Telephone Number : 337-451-4817
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2021
Last Update Date : 07/16/2021

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