Individual
MARY GROSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4630 RIVER RD N STE A, KEIZER, OR 97303-4648
(503) 304-2225
(503) 304-2226
Mailing address
4630 RIVER RD N STE A, KEIZER, OR 97303-4648
(503) 304-2225
(503) 304-2226
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16360
OR
Other
Enumeration date
10/03/2016
Last updated
10/03/2016
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