Provider Demographics
NPI:1518376128
Name:NAANA BRALY THERAPEUTIC MASSAGE &BODYWORK
Entity type:Organization
Organization Name:NAANA BRALY THERAPEUTIC MASSAGE &BODYWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRALY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-326-9640
Mailing Address - Street 1:8520 EAST SHEA BLVD SUITE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:480-588-6924
Mailing Address - Fax:480-634-5819
Practice Address - Street 1:8520 EAST SHEA BLVD SUITE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-588-6924
Practice Address - Fax:480-634-5819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-07
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT17946273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit