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Organization
RUNNER'S THERAPEUTIC MASSAGE
Active
Organization
RUNNER'S THERAPEUTIC MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACEY RUNNER LMT (OWNER)
(503) 395-0125
Entity
Organization
Contact information
Practice address
3860 RIVER RD N, KEIZER, OR 97303-4886
(503) 395-0125
Mailing address
1540 FIRCREST CT SE, SALEM, OR 97306-1336
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20959
OR
Other
Enumeration date
11/08/2014
Last updated
11/08/2014
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