MEDICARE: MISS SHAINA LYNN SAWYER LMT, CLT

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
2	3747P1801X	Personal Care Attendant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7501005570	OTHER	MI	MASSAGE THERAPY

General Provider Information

NPI Number	:	1952019226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SHAINA LYNN SAWYER LMT, CLT

Provider Business Mailing Address
First Line	:	5423 WASHINGTON AVE
Second Line	:
City	:	SAINT JOSEPH
State	:	MI
Zip	:	49085-9789
Country	:	US
Telephone Number	:	734-881-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	5423 WASHINGTON AVE
Second Line	:
City	:	SAINT JOSEPH
State	:	MI
Zip	:	49085-9789
Country	:	US
Telephone Number	:	734-881-2000
Fax Number	:

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

Provider Enumeration Date	:	11/07/2022
Last Update Date	:	11/07/2022

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