Provider Demographics
NPI:1891211835
Name:RICE, BRENNA MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:BRENNA
Middle Name:MARIE
Last Name:RICE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4288 N COUNTY ROAD 73C
Mailing Address - Street 2:
Mailing Address - City:RED FEATHER LAKES
Mailing Address - State:CO
Mailing Address - Zip Code:80545-8732
Mailing Address - Country:US
Mailing Address - Phone:720-456-9784
Mailing Address - Fax:
Practice Address - Street 1:4288 N COUNTY RD 73C
Practice Address - Street 2:
Practice Address - City:RED FEATHER LAKES
Practice Address - State:CO
Practice Address - Zip Code:80545
Practice Address - Country:US
Practice Address - Phone:970-295-4655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist