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NPI Code Detail

MEDICARE: MS. EMILY SARAH BRACY MASSAGE THERAPIST

MEDICARE: MS. EMILY SARAH BRACY MASSAGE THERAPIST
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
1174400000XSpecialist0019005476VA

General Provider Information

NPI Number : 1659705945
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. EMILY SARAH BRACY MASSAGE THERAPIST
Provider Business Mailing Address
First Line : 1310 GILCHRIST CT
Second Line :
City : RICHMOND
State : VA
Zip : 23231-5110
Country : US
Telephone Number : 434-401-7800
Fax Number :
Provider Business Practice Location Address
First Line : 1310 GILCHRIST CT
Second Line :
City : RICHMOND
State : VA
Zip : 23231-5110
Country : US
Telephone Number : 434-401-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2013
Last Update Date : 08/22/2013

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