Individual
CARLIE GABRIEL O'LEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
184 SE OAK ST, DALLAS, OR 97338-1912
(503) 544-6649
Mailing address
1180 SW FORESTRY LN, DALLAS, OR 97338-9590
(503) 544-6649
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16055
OR
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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