MEDICARE: MR. CURTIS BRAZEE LMT, CMMP, CPT

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	MT.0020731	CO

General Provider Information

NPI Number	:	1518564558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CURTIS BRAZEE LMT, CMMP, CPT

Provider Business Mailing Address
First Line	:	6361 BEARCAT LOOP
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80925-1373
Country	:	US
Telephone Number	:	719-761-8035
Fax Number	:

Provider Business Practice Location Address
First Line	:	3604 GALLEY RD STE 304
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-4302
Country	:	US
Telephone Number	:	719-761-8035
Fax Number	:

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

Provider Enumeration Date	:	10/02/2020
Last Update Date	:	10/02/2020

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