Individual
DAVA NIMMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
550 SISKIYOU BLVD, ASHLAND, OR 97520-2138
(541) 488-6757
Mailing address
100 N GRAPE ST APT 303, MEDFORD, OR 97501-3151
(541) 531-2065
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22534
OR
Other
Enumeration date
09/01/2017
Last updated
09/01/2017
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