Glenn Breda, LMT
Massage Therapist in Bridgeport, CT. Individual provider (NPI-1).
NPI number1558035196
StatusActive
Last updated in NPPESAug 6, 2021
Details
- NPI
- 1558035196
- Entity type
- Individual (NPI-1)
- Name
- Glenn Breda
- Credential
- LMT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 6, 2021
- Certification date
- Aug 6, 2021
- Last updated
- Aug 6, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 001456 | CT | Yes |
| 225700000X | Massage Therapist | – | – |
Practice location
850 Atlantic St Unit 301Bridgeport, CT 06604-5269
Phone 203-953-2722
Mailing address
850 Atlantic St Unit 301Bridgeport, CT 06604-5269
Phone 203-953-2722
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