Montague D Brantley Jr.

Individual provider Active NPI Massage Therapist · Florence, SC

NPI 1407287337 · NPPES record last updated May 5, 2016

Key facts

NPI
1407287337
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
7741 (SC)
Practice address
600 E Palmetto St
Florence, SC 29506-2851
Phone
(843) 664-3608
Fax
(843) 667-4133
NPI assigned
Dec 3, 2013
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

LicenseStateTypeSpecialty
7741SCMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 7741 SC Yes

Addresses

Primary practice location

600 E Palmetto St
Florence, SC 29506-2851

Mailing address

600 E Palmetto St
Florence, SC 29506-2851
Phone (843) 664-3608

Other providers in Florence, SC

All providers in Florence, SC · Massage Therapist in South Carolina

Sources for this page

Verify at the official NPI Registry.