Individual
DR. LISSA MICHELLE MCNIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.D.
Contact information
Practice address
3654C S PACIFIC HWY, MEDFORD, OR 97501-8922
(541) 535-9210
Mailing address
P.O. BOX 1442, JACKSONVILLE, OR 97530
(541) 773-1073
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
1471
OR
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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