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NPI 1407359680

NPI 1407359680 : BRITTANY ELAINE PIERCE : EAST SYRACUSE, NY

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General NPI Number Information
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    NPI Number           |    1407359680
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    Entity Type          |    Individual 
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    Provider Name        |    BRITTANY ELAINE PIERCE
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/14/2018
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    Last Update Date     |    03/14/2018
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Provider Practice Location Address
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    Address Line         |    6515 BASILE ROWE 
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    City                 |    EAST SYRACUSE
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    State                |    NY
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    Zip                  |    13057-2928
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    Country              |    US
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    Telephone            |    315-569-6579
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    112 ROCKLAND DR 
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    City                 |    NORTH SYRACUSE
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    State                |    NY
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    Zip                  |    13212-2702
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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       |    024525
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    License Number State |    NY
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