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NPI Code Detail

MEDICARE: LISA NADA GLINES L.M.T.

MEDICARE:   LISA NADA GLINES  L.M.T.
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 TherapistMT4527ME

General Provider Information

NPI Number : 1952608853
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA NADA GLINES L.M.T.
Provider Business Mailing Address
First Line : 747 SLIGO RD
Second Line :
City : NORTH YARMOUTH
State : ME
Zip : 04097-6207
Country : US
Telephone Number : 603-630-4261
Fax Number :
Provider Business Practice Location Address
First Line : 747 SLIGO RD
Second Line :
City : NORTH YARMOUTH
State : ME
Zip : 04097-6207
Country : US
Telephone Number : 603-630-4261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2011
Last Update Date : 02/12/2011

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Directions to “ LISA NADA GLINES L.M.T.” Practice Location

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