MEDICARE: MEGAN A CARGILL 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
1	225700000X	Massage Therapist	020677	OH

General Provider Information

NPI Number	:	1972840858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN A CARGILL LMT

Provider Business Mailing Address
First Line	:	5410 DORR ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-3610
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5410 DORR ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-3610
Country	:	US
Telephone Number	:	419-944-6709
Fax Number	:

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

Provider Enumeration Date	:	01/11/2013
Last Update Date	:	01/11/2013

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