Individual
CRYSTAL RENEA LOCKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
701 S LAKE ST, JOSEPH, OR 97846
(541) 432-3011
Mailing address
PO BOX 531, 701 S LAKE ST, JOSEPH, OR 97846
(541) 432-3011
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7487
OR
Other
Enumeration date
11/16/2010
Last updated
11/16/2010
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