Individual
GRETCHEN LANDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC, LMT
Contact information
Practice address
1332 MAIN ST., PHILOMATH, OR 97370
(541) 929-7462
Mailing address
PO BOX 968, PHILOMATH, OR 97370-0968
(541) 929-7462
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00294
OR
Other
Enumeration date
10/31/2006
Last updated
07/08/2007
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