MEDICARE: ROXANNE V STORY NVMT.12998MT.0027161

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	MT.0027161	CO
2	225700000X	Massage Therapist	NVMT.12998	NV

General Provider Information

NPI Number	:	1992655666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROXANNE V STORY NVMT.12998MT.0027161

Provider Business Mailing Address
First Line	:	9322 BOULDER OPAL AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-3861
Country	:	US
Telephone Number	:	970-773-3971
Fax Number	:

Provider Business Practice Location Address
First Line	:	9322 BOULDER OPAL AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-3861
Country	:	US
Telephone Number	:	970-773-3971
Fax Number	:

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

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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