Individual
BRIANA MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1061 109TH AVE NE, BLAINE, MN 55434-3846
(763) 208-4562
Mailing address
11524 JEFFERSON ST NE, BLAINE, MN 55434-1805
(612) 619-5316
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
MN
Other
Enumeration date
05/13/2010
Last updated
05/13/2010
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