Tasha Bruley, LMT
Individual provider Active NPI Massage Therapist · Grand Forks, ND
NPI 1467867945 · NPPES record last updated Jun 24, 2014
Key facts
- NPI
- 1467867945
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- Practice address
- 3165 Demers Ave
Grand Forks, ND 58201-4049 - Phone
- (701) 780-3458
- NPI assigned
- Jun 24, 2014
- Sex
- Female
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | ND | Yes |
Addresses
Primary practice location
3165 Demers Ave
Grand Forks, ND 58201-4049
Mailing address
3165 Demers Ave
Grand Forks, ND 58201-4049
Phone (701) 780-3458
Other providers in Grand Forks, ND
- Leon Pernell Brown
- Michael R Brown
- Tiana Christina Brown
- Kyle James Brownfield
- Jake Brozek
- Alixandria D Brumitt
- Ronald W Brummer
- Laurie Ann Brustad Kennedy
- Carlie Buchli
- Samantha Whitney Buck
All providers in Grand Forks, ND · Massage Therapist in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2014. 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.