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NPI Code Detail

MEDICARE: EDWIN NEZ LMT

MEDICARE: EDWIN NEZ 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 TherapistMT-21241AZ

General Provider Information

NPI Number : 1902454994
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWIN NEZ LMT
Provider Business Mailing Address
First Line : 2942 N 24TH ST STE 209
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-7850
Country : US
Telephone Number : 480-285-5581
Fax Number :
Provider Business Practice Location Address
First Line : 2701 N 7TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85006-1004
Country : US
Telephone Number : 602-307-0888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2019
Last Update Date : 09/03/2019

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Directions to “ EDWIN NEZ LMT” Practice Location

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