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General NPI Number Information
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NPI Number | 1659705945
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Entity Type | Individual
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Provider Name | EMILY SARAH BRACY MASSAGE THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 08/22/2013
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Last Update Date | 08/22/2013
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Provider Practice Location Address
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Address Line | 1310 GILCHRIST CT
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City | RICHMOND
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State | VA
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Zip | 23231-5110
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Country | US
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Telephone | 434-401-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 1310 GILCHRIST CT
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City | RICHMOND
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State | VA
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Zip | 23231-5110
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Country | US
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Telephone | 434-401-7800
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 0019005476
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License Number State | VA
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