Individual
PORTIA BRANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1000 LAFAYETTE BLVD # 1107, BRIDGEPORT, CT 06604-4725
(203) 727-5368
Mailing address
270 PLATT ST, BRIDGEPORT, CT 06606-2945
(203) 727-5368
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11341
CT
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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