Healthcare Provider Details

I. General information

NPI: 1396072229
Provider Name (Legal Business Name): BRIANNA JANELLE RANTE L.M.T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 11/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 EASTON ST NE
CANTON OH
44721-2623
US

IV. Provider business mailing address

2690 EASTON ST NE
CANTON OH
44721-2623
US

V. Phone/Fax

Practice location:
  • Phone: 330-491-0381
  • Fax: 330-491-0388
Mailing address:
  • Phone: 330-491-0381
  • Fax: 330-491-0388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number33017648
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: