Healthcare Provider Details

I. General information

NPI: 1013458603
Provider Name (Legal Business Name): DEBORAH NEFF LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 03/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 US 31W BYP SUITE 203
BOWLING GREEN KY
42101-1703
US

IV. Provider business mailing address

PO BOX 2050
BOWLING GREEN KY
42102-2050
US

V. Phone/Fax

Practice location:
  • Phone: 270-783-4500
  • Fax: 270-904-1771
Mailing address:
  • Phone: 270-783-4500
  • Fax: 270-904-1771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number165484
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: