Provider Demographics
NPI:1659813939
Name:ZANG, BRIANNA RAE
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:RAE
Last Name:ZANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 TRACY LN
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-8016
Mailing Address - Country:US
Mailing Address - Phone:858-243-2244
Mailing Address - Fax:
Practice Address - Street 1:20 AIRPORT RD STE 200
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-2054
Practice Address - Country:US
Practice Address - Phone:858-243-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-17
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20950225700000X
INMT22308193225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist