Healthcare Provider Details

I. General information

NPI: 1487023891
Provider Name (Legal Business Name): APPLIED THERAPEUTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2015
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 SE MOSHER AVE
ROSEBURG OR
97470-3961
US

IV. Provider business mailing address

2259 NW TROOST ST
ROSEBURG OR
97471-1710
US

V. Phone/Fax

Practice location:
  • Phone: 541-505-6912
  • Fax:
Mailing address:
  • Phone: 541-505-6912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. JUSTIN BRANDMEIER I
Title or Position: PRESIDENT & THERAPIST
Credential: LMT
Phone: 541-505-6912