Individual
MRS. BRENDA ROYCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
519 72ND ST, SPRINGFIELD, OR 97478-4220
(541) 521-7133
Mailing address
519 72ND ST, SPRINGFIELD, OR 97478-4220
(541) 521-7133
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24874
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24874
OBMT
OR
Enumeration date
04/19/2019
Last updated
04/19/2019
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