Individual
MR. JACKSON LEE ANDREWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
7380 SW REIF RD, POWELL BUTTE, OR 97753-1513
(541) 213-0491
Mailing address
7380 SW REIF RD, POWELL BUTTE, OR 97753-1513
(541) 213-0491
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20031
OR
Other
Enumeration date
01/24/2014
Last updated
01/24/2014
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