MEDICARE: STEPHENIE LEFEVERS

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	119095	TX

General Provider Information

NPI Number	:	1154875680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHENIE LEFEVERS

Provider Business Mailing Address
First Line	:	1082 OAK BEND DR
Second Line	:
City	:	KAUFMAN
State	:	TX
Zip	:	75142-5338
Country	:	US
Telephone Number	:	972-259-7179
Fax Number	:

Provider Business Practice Location Address
First Line	:	724 E US HIGHWAY 80 STE 200
Second Line	:
City	:	FORNEY
State	:	TX
Zip	:	75126-8720
Country	:	US
Telephone Number	:	972-259-7179
Fax Number	:

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

Provider Enumeration Date	:	08/13/2016
Last Update Date	:	08/13/2016

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Directions to “ STEPHENIE LEFEVERS ” Practice Location

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