Individual
MS. KELLY SKOVLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1617 4TH ST, LA GRANDE, OR 97850-2505
(541) 786-3707
Mailing address
1617 4TH STREET, LA GRANDE, OR 97850-0000
(541) 786-3707
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14065
OR
Other
Enumeration date
07/23/2007
Last updated
12/10/2009
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