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General NPI Number Information
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NPI Number | 1780345371
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Entity Type | Individual
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Provider Name | ROBERT MICHAEL BREINHOLT LMT
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Gender | Male
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Dates
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Enumeration Date | 01/05/2022
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 659 COTTAGE ST NE
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City | SALEM
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State | OR
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Zip | 97301-2419
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Country | US
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Telephone | 503-931-9237
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Fax | 503-386-2263
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Provider Business Mailing Address
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Address Line | PO BOX 13417
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City | SALEM
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State | OR
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Zip | 97309-1417
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Country | US
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Telephone | 503-931-9237
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Fax | 503-386-2263
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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 | 26479
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License Number State | OR
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