Most Relevant Information
Provider Data
| NPI Number: | 1003397027 |
| Provider Name: | GINA BRANNAGAN |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 6239 |
Most Important Dates
| Enumeration Date: | 08/27/2018 |
| Last Updated: | 08/27/2018 |
Provider Practice Location
4706 MAGNOLIA RIDGE DR
WAXHAW
NC
281739020
Practice Location Phone/Fax
| Phone: | 7042192655 |
| Fax: |
Provider Mailing Location
PO BOX 42
WAXHAW
NC
281731038
Provider Mailing Phone/Fax
| Phone: | 7042192655 |
| Fax: |