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NPI 1962633768

NPI 1962633768 : BRITNII LEIGH-ANNE ISAACKS L.M.T. : SALEM, MARION

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General NPI Number Information
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    NPI Number           |    1962633768
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    Entity Type          |    Individual 
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    Provider Name        |    BRITNII LEIGH-ANNE ISAACKS L.M.T.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/29/2009
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    Last Update Date     |    07/29/2009
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Provider Practice Location Address
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    Address Line         |    3488 PECK AVE SE 
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    City                 |    SALEM
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    State                |    MARION
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    Zip                  |    97302
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    Country              |    UM
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    Telephone            |    503-857-8196
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3488 PECK AVE SE 
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    City                 |    SALEM
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    State                |    OR
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    Zip                  |    97302-3312
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    Country              |    US
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    Telephone            |    503-857-8196
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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        |    175L00000X
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    Taxonomy Name        |    Homeopath
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    License Number       |    15091
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    License Number State |    OR
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