Rebecca Brancheau, LMT
Specialist in Portage, MI. Individual provider (NPI-1).
NPI number1972952182
StatusActive
Last updated in NPPESApr 25, 2017
Details
- NPI
- 1972952182
- Entity type
- Individual (NPI-1)
- Name
- Rebecca Brancheau
- Credential
- LMT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 8, 2016
- Last updated
- Apr 25, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 7501004536 | MI | Yes |
Practice location
1125 E Milham AveSuite C
Portage, MI 49002-3096
Phone 269-220-5033
Mailing address
1125 E Milham AveSuite C
Portage, MI 49002-3096
Phone 269-220-5033
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