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BRENNAN D LUNDGREN

>> Massage Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1609540889

Individual Registrant:
 BRENNAN D LUNDGREN 
Gender: M
Sole Proprietor

Location and contact information for practice:
5736 CHARLESTON ST  DANIA BEACH, FL 33021-3302 US
Tel: 954-512-8284  Fax: --

Contact information for business:
5736 CHARLESTON ST  DANIA BEACH, FL 33021 US
Tel: 954-512-8284  Fax: --

Registration Information:
NPI: 1609540889
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N225700000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Massage Therapist
MA85903
Y225700000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Massage Therapist
FLMA85903

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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