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General NPI Number Information
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NPI Number | 1700363983
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Entity Type | Organization
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Legal Business Name | BRAWNERGY MASSAGE & BODYWORK
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Dates
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Enumeration Date | 07/20/2018
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Last Update Date | 07/20/2018
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Provider Practice Location Address
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Address Line | 27393 YNEZ RD STE 151
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City | TEMECULA
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State | CA
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Zip | 92591-4605
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Country | US
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Telephone | 951-200-4245
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Fax |
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Provider Business Mailing Address
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Address Line | 27393 YNEZ RD STE 151
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City | TEMECULA
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State | CA
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Zip | 92591-4605
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Country | US
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Telephone | 951-200-4245
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RACHEL BRAWNER
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Credential | CMT
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Telephone | 951-200-4245
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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 | 32335
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License Number State | CA
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