Individual
JENNIFER DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2115 TRILLIUM ST, EUGENE, OR 97405-1378
(808) 258-8377
Mailing address
2115 TRILLIUM ST, EUGENE, OR 97405-1378
(808) 258-8377
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22370
OR
Other
Enumeration date
12/03/2016
Last updated
12/03/2016
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