Individual
PHILIP BROGDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
14028 N HIGHWAY 183 STE D120, AUSTIN, TX 78717-5992
(512) 250-8800
Mailing address
14028 N HIGHWAY 183 STE D120, AUSTIN, TX 78717-5992
(512) 250-8800
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT121606
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT121606
LMT
TX
Enumeration date
10/29/2017
Last updated
10/29/2017
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