Individual
JENNIFER LYNN LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2596 E BARNETT RD STE B, MEDFORD, OR 97504-4340
(541) 727-1996
Mailing address
495 LYNN ST, ASHLAND, OR 97520-1222
(513) 382-2587
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21804
OR
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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