Healthcare Provider Details

I. General information

NPI: 1033452172
Provider Name (Legal Business Name): THOMAS BRIEGEL LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6027 N BRADY ST SUITE 'A' - SOOTHINGTOUCHWELLNESSCENTER.COM
DAVENPORT IA
52806-2100
US

IV. Provider business mailing address

3953 HIGHWAY 61
BLUE GRASS IA
52726-9424
US

V. Phone/Fax

Practice location:
  • Phone: 563-340-6637
  • Fax:
Mailing address:
  • Phone: 563-340-6637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number02881
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number02881
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: