Healthcare Provider Details

I. General information

NPI: 1407700107
Provider Name (Legal Business Name): BRIAN ALLEN RUMPZA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2026
Last Update Date: 02/21/2026
Certification Date: 02/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18322 JOPLIN ST NW
ELK RIVER MN
55330-1773
US

IV. Provider business mailing address

17865 ROUND LAKE BLVD NW
ANDOVER MN
55304-1210
US

V. Phone/Fax

Practice location:
  • Phone: 763-441-0999
  • Fax:
Mailing address:
  • Phone: 763-441-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberC943056849416
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: