MEDICARE: PATRICIA GEFFRE-STARR

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	227009527	AZ

General Provider Information

NPI Number	:	1336549427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA GEFFRE-STARR

Provider Business Mailing Address
First Line	:	6516 S ADAMS ST
Second Line	:
City	:	BARTONVILLE
State	:	IL
Zip	:	61607-2559
Country	:	US
Telephone Number	:	309-338-3581
Fax Number	:

Provider Business Practice Location Address
First Line	:	3322 W WILLOW KNOLLS DR
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61614-8148
Country	:	US
Telephone Number	:	309-690-3322
Fax Number	:	309-690-3323

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

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	08/26/2014

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Directions to “ PATRICIA GEFFRE-STARR ” Practice Location

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