MEDICARE: TIPHANIE M HARVEY LMT

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	12101-146	WI

General Provider Information

NPI Number	:	1518771880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIPHANIE M HARVEY LMT

Provider Business Mailing Address
First Line	:	4205 TANGLEWOOD DR
Second Line	:
City	:	JANESVILLE
State	:	WI
Zip	:	53546-8844
Country	:	US
Telephone Number	:	608-728-1124
Fax Number	:

Provider Business Practice Location Address
First Line	:	42 MERCHANT ROW
Second Line	:
City	:	MILTON
State	:	WI
Zip	:	53563-1135
Country	:	US
Telephone Number	:	608-728-1124
Fax Number	:

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

Provider Enumeration Date	:	02/05/2025
Last Update Date	:	02/05/2025

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