MEDICARE: NADIA VAZQUEZ 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	007461	TN

General Provider Information

NPI Number	:	1952751653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADIA VAZQUEZ MASSAGE THERAPIST

Provider Business Mailing Address
First Line	:	P O BOX 322
Second Line	:
City	:	CALHOUN
State	:	GA
Zip	:	30703
Country	:	US
Telephone Number	:	706-844-5146
Fax Number	:	706-625-3585

Provider Business Practice Location Address
First Line	:	110 N WALL ST
Second Line	:
City	:	CALHOUN
State	:	GA
Zip	:	30701-2242
Country	:	US
Telephone Number	:	706-844-5146
Fax Number	:

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

Provider Enumeration Date	:	06/14/2016
Last Update Date	:	06/14/2016

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