MEDICARE: VIVA STEP

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	25852

General Provider Information

NPI Number	:	1578269692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIVA STEP

Provider Business Mailing Address
First Line	:	125 N 2ND ST STE 110
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-2427
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2625 E GREENWAY PKWY STE 200
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-4369
Country	:	US
Telephone Number	:	602-718-2571
Fax Number	:

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

Provider Enumeration Date	:	01/31/2023
Last Update Date	:	01/31/2023

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Directions to “ VIVA STEP ” Practice Location

Language	Start Address	Practice Location

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