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NPI Code Detail

MEDICARE: BRENDON MICHAEL MORRILL

MEDICARE:   BRENDON MICHAEL MORRILL
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
1225700000XMassage TherapistMT4124ME

General Provider Information

NPI Number : 1124821038
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDON MICHAEL MORRILL
Provider Business Mailing Address
First Line : 500 FOREST AVE STE 5E
Second Line :
City : PORTLAND
State : ME
Zip : 04101-1520
Country : US
Telephone Number : 207-450-2732
Fax Number :
Provider Business Practice Location Address
First Line : 500 FOREST AVE STE 5E
Second Line :
City : PORTLAND
State : ME
Zip : 04101-1520
Country : US
Telephone Number : 207-450-2732
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2025
Last Update Date : 03/28/2025

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Directions to “ BRENDON MICHAEL MORRILL ” Practice Location

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