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General NPI Number Information
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NPI Number | 1033442595
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Entity Type | Individual
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Provider Name | BRENDA LYNN NORRIS LMT
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Gender | Female
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Dates
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Enumeration Date | 09/15/2009
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Last Update Date | 09/15/2009
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Provider Practice Location Address
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Address Line | 1850 BOYSCOUT DR # 108
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City | FT. MFYERS
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State | FL
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Zip | 33907
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Country | US
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Telephone | 239-275-4247
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Fax |
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Provider Business Mailing Address
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Address Line | 14831 SUMMERLIN WOODS DR #3
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City | FT. MYERS
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State | FL
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Zip | 33919
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Country | US
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Telephone | 239-994-0025
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA30680
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License Number State | FL
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