Marilyn Massad

Individual provider Active NPI Massage Therapist · Provincetown, MA

NPI 1477918993 · NPPES record last updated Dec 29, 2015

Key facts

NPI
1477918993
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
5875 (MA)
Practice address
5 Meadow Rd Unit 2
Provincetown, MA 02657-1256
Phone
(508) 776-8434
NPI assigned
Dec 29, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5875MAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 5875 MA Yes

Addresses

Primary practice location

5 Meadow Rd Unit 2
Provincetown, MA 02657-1256

Mailing address

5 Meadow Rd Unit 2
Provincetown, MA 02657-1256
Phone (508) 776-8434

Other providers in Provincetown, MA

All providers in Provincetown, MA · Massage Therapist in Massachusetts

Sources for this page

Verify at the official NPI Registry.