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General NPI Number Information
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NPI Number | 1487000584
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Entity Type | Individual
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Provider Name | BRETT OLEN MEYER LMT
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Gender | Male
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Dates
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Enumeration Date | 05/06/2016
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Last Update Date | 05/06/2016
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Provider Practice Location Address
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Address Line | 2000 E OAKLAND PARK BLVD SUITE 109
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1120
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Country | US
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Telephone | 954-566-4222
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Fax | 954-766-4688
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Provider Business Mailing Address
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Address Line | 2805 E OAKLAND PARK BLVD 446
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1813
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Country | US
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Telephone | 954-804-0303
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Fax | 954-766-4688
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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 | MA17378
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License Number State | FL
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