Individual
KATRINA E KEIDEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
955 ISLAND ST, SPRINGFIELD, OR 97477-3523
(541) 510-0601
Mailing address
955 ISLAND ST, SPRINGFIELD, OR 97477-3523
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10444
OR
Other
Enumeration date
11/29/2021
Last updated
11/29/2021
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