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Individual

KELLY VITTORIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT, NCTMB

Contact information

Practice address
280 E HERSEY ST, B17, ASHLAND, OR 97520-1293
(541) 414-8124
Mailing address
195 RIDGE RD, ASHLAND, OR 97520-2826
(541) 414-8124

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19608
OR

Other

Enumeration date
03/05/2013
Last updated
03/05/2013
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