Individual provider · NPI-1

Brandon Ray Fernandez, CMT

Massage Therapist · Indio, CA

NPI number1235906264
StatusActive
Last updated in NPPESDec 11, 2023

Details

NPI
1235906264
Entity type
Individual (NPI-1)
Name
Brandon Ray Fernandez
Credential
CMT
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 11, 2023
Certification date
Dec 9, 2023
Last updated
Dec 11, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage Therapist90494CAYes

Practice location

48352 Keaton Way
Indio, CA 92201-8460

Phone 442-400-9544

Mailing address

48352 Keaton Way
Indio, CA 92201-8460

Phone 442-400-9544

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