MEDICARE: RACHEL FREY CMT

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	88779	CA

General Provider Information

NPI Number	:	1881325173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL FREY CMT

Provider Business Mailing Address
First Line	:	1159 LOGAN ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-3210
Country	:	US
Telephone Number	:	323-238-9185
Fax Number	:

Provider Business Practice Location Address
First Line	:	1159 LOGAN ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-3210
Country	:	US
Telephone Number	:	323-238-9185
Fax Number	:

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

Provider Enumeration Date	:	06/18/2022
Last Update Date	:	03/18/2024

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Directions to “ RACHEL FREY CMT” Practice Location

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