Larry Brown, LMT
Individual provider Active NPI Massage Therapist · Yulee, FL
NPI 1275344699 · NPPES record last updated Jan 15, 2025
Key facts
- NPI
- 1275344699
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA100385 (FL)
- Practice address
- 850772 US Highway 17
Yulee, FL 32097-9648 - Phone
- (904) 582-9779
- NPI assigned
- Jan 15, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA100385 | FL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA100385 | FL | Yes |
Addresses
Primary practice location
850772 US Highway 17
Yulee, FL 32097-9648
Mailing address
850772 US Highway 17
Yulee, FL 32097-9648
Phone (904) 582-9779
Other providers in Yulee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.