Provider Demographics
NPI:1124749049
Name:INFANT MASSAGE WITH BRI
Entity type:Organization
Organization Name:INFANT MASSAGE WITH BRI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAGGART
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC, CEIM
Authorized Official - Phone:801-652-2116
Mailing Address - Street 1:1223 E GREEN RD
Mailing Address - Street 2:
Mailing Address - City:FRUIT HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84037-2245
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:866-507-7384
Practice Address - Street 1:1223 E GREEN RD
Practice Address - Street 2:
Practice Address - City:FRUIT HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84037-2245
Practice Address - Country:US
Practice Address - Phone:801-652-2116
Practice Address - Fax:866-507-7384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health