Individual
DIANE MARIE BRAUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
655 A STREET, SUITE B, SPRINGFIELD, OR 97477
(541) 484-5322
Mailing address
PO BOX 583, COTTAGE GROVE, OR 97424
(541) 484-5322
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
#3142
OR
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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