Individual
MISS KALI LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
235 SE DAVIS AVE, BEND, OR 97701
(541) 408-3510
Mailing address
63358 PETERMAN LN, BEND, OR 97701
(541) 408-3510
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12439
OR
Other
Enumeration date
06/01/2015
Last updated
07/21/2022
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