Individual
MRS. BRIANNE RACINE MANNINEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
3508 LARAMIE DR STE 3, BOZEMAN, MT 59718-2006
(503) 803-2017
Mailing address
3508 LARAMIE DR STE 3, BOZEMAN, MT 59718-2006
(503) 803-2017
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC 60122573
WA
171100000X
Acupuncturist
MED-ACU-LIC-14656
MT
Other
Enumeration date
11/30/2010
Last updated
03/15/2012
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