Individual
KYLIE ECCLESTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6250 CLUB HOUSE DR SE, SALEM, OR 97306-9329
(503) 580-8762
Mailing address
870 SAHALEE CT SE, SALEM, OR 97306-9140
(503) 580-8762
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25470
OR
Other
Enumeration date
03/07/2024
Last updated
03/07/2024
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