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General NPI Number Information
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NPI Number | 1366940900
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Entity Type | Individual
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Provider Name | HOLLIE BRUMLEY
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Gender | Female
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Dates
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Enumeration Date | 01/29/2018
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Last Update Date | 01/29/2018
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Provider Practice Location Address
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Address Line | 504 WILLIAMS
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City | MAYSVILLE
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State | OK
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Zip | 73057-3679
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Country | US
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Telephone | 405-867-4404
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Fax |
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Provider Business Mailing Address
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Address Line | 837 COUNTY ROAD 1570
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City | MARLOW
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State | OK
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Zip | 73055-6603
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Country | US
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Telephone |
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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 |
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License Number State |
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