MEDICARE: MARCUS GREER LMT, MMP

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	NVMT.6621	NV

General Provider Information

NPI Number	:	1831758903
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUS GREER LMT, MMP

Provider Business Mailing Address
First Line	:	316 GEMSTONE HILL AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-6862
Country	:	US
Telephone Number	:	702-812-2246
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 GEMSTONE HILL AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-6862
Country	:	US
Telephone Number	:	702-812-2246
Fax Number	:

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

Provider Enumeration Date	:	06/11/2019
Last Update Date	:	06/11/2019

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