Provider Demographics
NPI:1861630212
Name:SEABORG, BRITTINA ANN (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:BRITTINA
Middle Name:ANN
Last Name:SEABORG
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 4TH AVE NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WAITE PARK
Mailing Address - State:MN
Mailing Address - Zip Code:56387-1295
Mailing Address - Country:US
Mailing Address - Phone:651-231-4978
Mailing Address - Fax:
Practice Address - Street 1:307 4TH AVE NE
Practice Address - Street 2:SUITE A
Practice Address - City:WAITE PARK
Practice Address - State:MN
Practice Address - Zip Code:56387-1295
Practice Address - Country:US
Practice Address - Phone:651-231-4978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist