Provider Demographics
NPI:1831861996
Name:AB MASSAGE THREAPY, PLLC
Entity type:Organization
Organization Name:AB MASSAGE THREAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:NACOLE
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:928-235-8821
Mailing Address - Street 1:1765 E VILLA DR STE A
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-5481
Mailing Address - Country:US
Mailing Address - Phone:928-235-8821
Mailing Address - Fax:
Practice Address - Street 1:1765 E VILLA DR STE A
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-5481
Practice Address - Country:US
Practice Address - Phone:928-235-8821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty