Individual
MS. LACEY ELIZABETH ROSE KLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
85458 HYWY 11, MILTON FREEWATER, OR 97862
(541) 938-8300
(541) 938-3924
Mailing address
85458 HYWY 11, MILTON FREEWATER, OR 97862
(541) 938-8300
(541) 938-3924
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24742
OR
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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