Individual
CHAD RAVERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1755 COBURG RD, EUGENE, OR 97401-4982
(541) 636-3100
(541) 636-3913
Mailing address
1755 COBURG RD, EUGENE, OR 97401-4982
(541) 636-3100
(541) 636-3913
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18978
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18978
STATE LICENSE
OR
Enumeration date
10/20/2014
Last updated
10/20/2014
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