Individual
GINA RAE MERRITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
108 E HERSEY ST # 2A, ASHLAND, OR 97520-1363
(760) 715-4977
Mailing address
220 4TH ST APT 4, ASHLAND, OR 97520-2049
(760) 715-4977
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21587
OR
Other
Enumeration date
06/17/2019
Last updated
11/12/2020
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