Individual
KAY MARIE NIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA, LMT
Contact information
Practice address
18255 REDWOOD HWY, SELMA, OR 97538-9729
(541) 218-0485
Mailing address
5050 LAKESHORE DRIVE, SELMA, OR 97538-9502
(541) 218-0485
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
03/20/2009
Last updated
03/20/2009
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