MEDICARE: VELVET NEFFENGER

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	021972	OH

General Provider Information

NPI Number	:	1376280800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VELVET NEFFENGER

Provider Business Mailing Address
First Line	:	342 WILMINGTON DR
Second Line	:
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-4402
Country	:	US
Telephone Number	:	440-351-9020
Fax Number	:

Provider Business Practice Location Address
First Line	:	342 WILMINGTON DR
Second Line	:
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-4402
Country	:	US
Telephone Number	:	440-351-9020
Fax Number	:

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

Provider Enumeration Date	:	05/17/2022
Last Update Date	:	05/17/2022

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Directions to “ VELVET NEFFENGER ” Practice Location

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