Provider Demographics
NPI:1548595036
Name:THERAPEUTIC MASSAGE & BODY WORKS BY BROWN & ASSOCIATES LLC.
Entity Type:Organization
Organization Name:THERAPEUTIC MASSAGE & BODY WORKS BY BROWN & ASSOCIATES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:SR
Authorized Official - Credentials:LMT
Authorized Official - Phone:754-422-1171
Mailing Address - Street 1:P.O. BOX 5845
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33310
Mailing Address - Country:US
Mailing Address - Phone:754-422-1171
Mailing Address - Fax:
Practice Address - Street 1:1800, N.W. 55 AVE
Practice Address - Street 2:U4
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313
Practice Address - Country:US
Practice Address - Phone:754-422-1171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA52518225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty