MEDICARE: MR. BREONE L DUPREE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT22207650	IN

General Provider Information

NPI Number	:	1093643785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BREONE L DUPREE

Provider Business Mailing Address
First Line	:	4040 S MERIDIAN ST STE 6
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46217-3310
Country	:	US
Telephone Number	:	317-758-8854
Fax Number	:

Provider Business Practice Location Address
First Line	:	4040 S MERIDIAN ST STE 6
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46217-3310
Country	:	US
Telephone Number	:	317-758-8854
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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Directions to “ MR. BREONE L DUPREE ” Practice Location

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