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Individual
MR. SPENCER TODD DAVIS
Active
Individual
MR. SPENCER TODD DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
23590
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23590
OREGON BOARD OF MASSAGE
OR
Enumeration date
05/05/2018
Last updated
05/05/2018
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