Individual
AMBER DAWN CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
1554 NE 4TH ST STE 3, BEND, OR 97701-4240
(541) 419-2390
Mailing address
PO BOX 2211, REDMOND, OR 97756-0540
(541) 419-2390
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26974
OR
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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