Provider Demographics
NPI:1750080651
Name:COMINGS, BRANDI AUTUMN (LMT)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:AUTUMN
Last Name:COMINGS
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 1:2404 CALCITE ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-2003
Mailing Address - Country:US
Mailing Address - Phone:970-373-7619
Mailing Address - Fax:
Practice Address - Street 1:4689 W 20TH ST UNIT G
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-3218
Practice Address - Country:US
Practice Address - Phone:970-373-7619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0008536225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist