Individual
MARY THERESA NOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3523 PACIFIC BLVD SW, ALBANY, OR 97321-7727
(541) 714-3275
Mailing address
6058 CARROL PL SW, ALBANY, OR 97321-3639
(352) 586-8470
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24873
OR
Other
Enumeration date
01/30/2019
Last updated
01/30/2019
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