Individual
KEITH KILLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
568 NE SAVANNAH DR STE 5, BEND, OR 97701-4866
(541) 668-1881
(888) 658-6924
Mailing address
61174 BROOKHOLLOW DR, BEND, OR 97702-2777
(541) 408-3681
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-26571
OR
Other
Enumeration date
10/30/2023
Last updated
10/30/2023
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