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General NPI Number Information
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NPI Number | 1356280523
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Entity Type | Individual
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Provider Name | BRANDON MORISE PIPPEN
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Gender | Male
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Dates
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Enumeration Date | 03/25/2026
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Last Update Date | 03/25/2026
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Provider Practice Location Address
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Address Line | 1806 ROBINHOOD BLVD STE 5
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City | SCHERERVILLE
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State | IN
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Zip | 46375-1824
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Country | US
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Telephone | 219-232-6260
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Fax |
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Provider Business Mailing Address
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Address Line | 2617 HART ST
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City | DYER
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State | IN
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Zip | 46311-2119
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Country | US
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Telephone | 219-232-6260
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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 | MT22308081
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License Number State | IN
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