Individual
JENNIFER LOUISE WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
94260 HORTON RD, BLACHLY, OR 97412-9755
(541) 321-6023
Mailing address
94260 HORTON RD, BLACHLY, OR 97412-9755
(541) 321-6023
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25120
OR
Other
Enumeration date
06/24/2019
Last updated
06/24/2019
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