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STEPHANIE JANE BRACKEEN LMT

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

Registrant NPI Number: 1366043903

Individual Registrant:
 STEPHANIE JANE BRACKEEN LMT
Gender: F
Not Sole Proprietor

Location and contact information for practice:
95 BASSINGHAM DR  BELLA VISTA, AR 72715-1526 US
Tel: 760-421-2303  Fax: --

Contact information for business:
95 BASSINGHAM DR  BELLA VISTA, AR 72715-1526 US
Tel: 760-421-2303  Fax: --

Registration Information:
NPI: 1366043903
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225700000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Massage Therapist
NY031998

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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