Individual
GRACE BANTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1250 NYSSA ST, JUNCTION CITY, OR 97448-1268
(541) 556-5381
Mailing address
489 STERLING DR, EUGENE, OR 97404-2291
(541) 556-5381
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28419
OR
Other
Enumeration date
10/14/2025
Last updated
10/14/2025
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