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NPI Code Detail

MEDICARE: ANTHONY RYAN BROWN LMT

MEDICARE:   ANTHONY RYAN BROWN  LMT
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 Therapist12999OR

General Provider Information

NPI Number : 1932204104
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY RYAN BROWN LMT
Provider Business Mailing Address
First Line : 380 Q ST
Second Line :
City : SPRINGFIELD
State : OR
Zip : 97477-2120
Country : US
Telephone Number : 541-606-5954
Fax Number :
Provider Business Practice Location Address
First Line : 380 Q ST
Second Line :
City : SPRINGFIELD
State : OR
Zip : 97477-2120
Country : US
Telephone Number : 541-606-5954
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 02/02/2022

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Directions to “ ANTHONY RYAN BROWN LMT” Practice Location

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