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NPI Code Detail

MEDICARE: BRANDEN R SMITH LMMT

MEDICARE: BRANDEN R SMITH LMMT
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 TherapistVA

General Provider Information

NPI Number : 1811839053
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDEN R SMITH LMMT
Provider Business Mailing Address
First Line : 1216 BAINBRIDGE ST
Second Line :
City : RICHMOND
State : VA
Zip : 23224-2134
Country : US
Telephone Number : 757-528-7958
Fax Number :
Provider Business Practice Location Address
First Line : 4906 FITZHUGH AVE STE 100
Second Line :
City : RICHMOND
State : VA
Zip : 23230-3520
Country : US
Telephone Number : 804-592-6728
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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