Individual
NICOLE C TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
146 CHIEF MIWALETA LN, CANYONVILLE, OR 97417-9700
(541) 839-1111
Mailing address
152 NW BREE DR, WINSTON, OR 97496-9550
(541) 606-0532
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19670
OR
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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