Individual
MAXX QUINTON NEWBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1245 CHARNELTON ST STE 9, EUGENE, OR 97401-6206
(541) 521-4765
Mailing address
1290 W 5TH AVE, EUGENE, OR 97402-4571
(541) 521-4765
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19616
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
832167663
—
OR
Enumeration date
11/13/2018
Last updated
02/19/2024
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