Provider Demographics
NPI:1902611106
Name:MUNSTERMAN, BRIAN (CMT)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:MUNSTERMAN
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10176 SHADY OAKS DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6918
Mailing Address - Country:US
Mailing Address - Phone:909-685-8930
Mailing Address - Fax:
Practice Address - Street 1:10176 SHADY OAKS DR UNIT A
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6918
Practice Address - Country:US
Practice Address - Phone:909-685-8930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA170553225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist