Brianne Kathryn Boettcher
Individual provider Active NPI Massage Therapist · Lockport, IL
NPI 1326652017 · NPPES record last updated Sep 1, 2020
Key facts
- NPI
- 1326652017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 227007971 (IL)
- Practice address
- 100 Macgregor Rd
Lockport, IL 60441-2712 - Phone
- (708) 218-7115
- NPI assigned
- Sep 1, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 227007971 | IL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 227007971 | IL | Yes |
Addresses
Primary practice location
100 Macgregor Rd
Lockport, IL 60441-2712
Mailing address
1014 Highland Ave
Lockport, IL 60441-2753
Phone (708) 218-7115
Other providers in Lockport, IL
- BH Care LLC
- Isabella Marie Bigos
- Margaret Mary Bitten
- Elizabeth Frances Blaha
- Gregory Paul Bobak
- Thomas Richard Brescia
- Bridges to a New Day,NFP
- Brightpath Lab LLC
- Jennifer Britt
- Anna Maris Labrado Briz
All providers in Lockport, IL · Massage Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2020. 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.