MEDICARE: PURRFECT MASSAGE, LLC

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

General Provider Information

NPI Number	:	1053143826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURRFECT MASSAGE, LLC

Provider Business Mailing Address
First Line	:	1341 RIDGE ST
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-1834
Country	:	US
Telephone Number	:	727-692-2023
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 S 8TH ST
Second Line	:
City	:	RICHMOND
State	:	IN
Zip	:	47374-5441
Country	:	US
Telephone Number	:	727-692-2023
Fax Number	:

Authorized Official
Title or Position	:	SOLE MANAGING MEMBER
Name	:	MS. CANDI MARIE HAMMER
Credential	:	LMT
Telephone Number	:	727-692-2023

Provider Enumeration Date	:	08/19/2024
Last Update Date	:	08/21/2024

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Directions to “PURRFECT MASSAGE, LLC ” Practice Location

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