MEDICARE: BRENNA CLAIRE MCCARTHY

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	MP1784	AK

General Provider Information

NPI Number	:	1649650946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENNA CLAIRE MCCARTHY

Provider Business Mailing Address
First Line	:	4034 REKA DR APT L3
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-3539
Country	:	US
Telephone Number	:	617-435-3420
Fax Number	:

Provider Business Practice Location Address
First Line	:	4034 REKA DR APT L3
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-3539
Country	:	US
Telephone Number	:	617-435-3420
Fax Number	:

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

Provider Enumeration Date	:	06/02/2015
Last Update Date	:	06/02/2015

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Directions to “ BRENNA CLAIRE MCCARTHY ” Practice Location

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