Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 5845 | OR |
NPI | 1003128729 |
---|---|
Provider Name | Mrs. Barbara Braunstein |
First Address | Selma, OR 97538-0845 |
Second Address | Selma, OR 97538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2010 |
Last Update Date | 10/07/2010 |