Individual
ELIZABETH BASTIDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1345 CENTER DR STE 100, MEDFORD, OR 97501-7945
(541) 210-5674
(541) 210-5674
Mailing address
1345 CENTER DR STE 100, MEDFORD, OR 97501-7945
(541) 210-5674
(541) 210-5674
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25272
OR
Other
Enumeration date
05/04/2020
Last updated
05/05/2020
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