Provider Demographics
NPI:1023747276
Name:PATTERSON, BRANDY C (LMT)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:C
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9950 N WILD CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-8400
Mailing Address - Country:US
Mailing Address - Phone:520-403-0025
Mailing Address - Fax:
Practice Address - Street 1:9950 N WILD CREEK DR # 9950
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85742-8400
Practice Address - Country:US
Practice Address - Phone:520-403-0025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-05
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-09811225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist