Individual
PATRICIA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
143 NW E ST, GRANTS PASS, OR 97526-2009
(541) 660-7701
Mailing address
193 MOSSFLOWER LN, GRANTS PASS, OR 97527-7658
(541) 660-7701
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21680
OR
Other
Enumeration date
10/14/2015
Last updated
10/14/2015
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