Individual
NANCY DE LAZZARO BRANNUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15886 GALE AVE, HACIENDA HEIGHTS, CA 91745-1601
(626) 852-0858
Mailing address
4070 N HARBOR BLVD, FULLERTON, CA 92835-1037
(626) 852-0858
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3144
CA
Other
Enumeration date
10/29/2013
Last updated
03/25/2015
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