NPI 1588415897 · live from the CMS NPI Registry
Brandon Tyler Ahlstedt, LMT
Massage Therapist in Ocean Springs, MS. National Provider Identifier 1588415897, active.
NPI record
| NPI | 1588415897 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 6819 Washington Ave Ste F, Ocean Springs, MS 39564 |
| Practice phone | 228-697-8860 |
| Mailing address | 2117 Boardman Blvd, Gulfport, MS 39507 |
| Enumerated | March 27, 2024 |
| Last updated | March 27, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | 2798 (MS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.