Provider Demographics
NPI:1699081307
Name:MORRISON, BRANDI N (LMT)
Entity type:Individual
Prefix:
First Name:BRANDI
Middle Name:N
Last Name:MORRISON
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 1:10934 N 56TH ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-3004
Mailing Address - Country:US
Mailing Address - Phone:813-988-7256
Mailing Address - Fax:813-464-7645
Practice Address - Street 1:10934 N 56TH ST
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-3004
Practice Address - Country:US
Practice Address - Phone:813-988-7256
Practice Address - Fax:813-464-7645
Is Sole Proprietor?:No
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA58009225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist