Individual
BRIAN SHOEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
102 LAPREE ST, TALENT, OR 97540-6002
(808) 377-0000
Mailing address
102 LAPREE ST, TALENT, OR 97540-6002
(808) 377-0000
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
023401
OR
225700000X
Massage Therapist
12794
HI
Other
Enumeration date
06/19/2016
Last updated
12/17/2017
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