MEDICARE: MR. ALONZO JEFFRIES

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	MSG011311	PA

General Provider Information

NPI Number	:	1649941295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALONZO JEFFRIES

Provider Business Mailing Address
First Line	:	300 ABBEYVILLE RD APT E
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15228-1737
Country	:	US
Telephone Number	:	412-390-7388
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 ABBEYVILLE RD APT E
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15228-1737
Country	:	US
Telephone Number	:	412-390-7388
Fax Number	:

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

Provider Enumeration Date	:	09/23/2021
Last Update Date	:	09/23/2021

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Directions to “ MR. ALONZO JEFFRIES ” Practice Location

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