MEDICARE: LEONIA GLOVER

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	MSG006325	PA

General Provider Information

NPI Number	:	1720872807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONIA GLOVER

Provider Business Mailing Address
First Line	:	1532 SAINT LUKE ST
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19140-1923
Country	:	US
Telephone Number	:	267-688-7823
Fax Number	:

Provider Business Practice Location Address
First Line	:	10980 NORCOM RD
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19154-2302
Country	:	US
Telephone Number	:	215-677-1149
Fax Number	:

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

Provider Enumeration Date	:	04/05/2025
Last Update Date	:	04/05/2025

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Directions to “ LEONIA GLOVER ” Practice Location

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