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Organization
RUSSIAN MASSAGE
Active
Organization
RUSSIAN MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELENA PETERS LMT (OWNER/LMT/AMMP)
(541) 604-5753
Entity
Organization
Contact information
Practice address
507 MAIN ST, KLAMATH FALLS, OR 97601-6031
(541) 604-5753
Mailing address
507 MAIN ST, KLAMATH FALLS, OR 97601-6031
(541) 604-5753
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19673
OR
Other
Enumeration date
05/09/2016
Last updated
06/01/2016
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