MEDICARE: EMILY BRUBAKER

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	MT015386	GA
2	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1558293407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY BRUBAKER

Provider Business Mailing Address
First Line	:	232 LINDA LN
Second Line	:
City	:	LAGRANGE
State	:	GA
Zip	:	30240-9100
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	232 LINDA LN
Second Line	:
City	:	LAGRANGE
State	:	GA
Zip	:	30240-9100
Country	:	US
Telephone Number	:	334-728-6699
Fax Number	:

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

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ EMILY BRUBAKER ” Practice Location

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