Individual
BRENNA UNDERWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
101 THREE RIVERS N # 112, FORT WAYNE, IN 46802-1312
(260) 710-0873
Mailing address
101 THREE RIVERS N # 112, FORT WAYNE, IN 46802-1312
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT22207714
IN
Other
Enumeration date
11/21/2022
Last updated
07/18/2025
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