MEDICARE: MR. ALAN JOHN THOMAS MASSAGE THERAPIST

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	MA 28706	FL

General Provider Information

NPI Number	:	1871700344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALAN JOHN THOMAS MASSAGE THERAPIST

Provider Business Mailing Address
First Line	:	5248 LAKE VILLAGE DR
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34235-2044
Country	:	US
Telephone Number	:	941-379-9168
Fax Number	:

Provider Business Practice Location Address
First Line	:	7274 55TH AVE E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34203-8002
Country	:	US
Telephone Number	:	941-752-4451
Fax Number	:

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	07/08/2007

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