Individual
JADA BRUEGGEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
4015 N ARMENIA AVE, TAMPA, FL 33607-1001
(813) 955-6742
(813) 873-2042
Mailing address
4015 N ARMENIA AVE, TAMPA, FL 33607-1001
(813) 955-6742
(813) 873-2042
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA17250
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA17250
FL STATE LICENSE NUMBER
FL
Enumeration date
04/09/2019
Last updated
04/09/2019
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