Individual
AMY ELIZABETH LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LMT
Contact information
Practice address
88138 DUNHAM LOOP, VENETA, OR 97487-8729
(541) 908-2336
Mailing address
88138 DUNHAM LOOP, VENETA, OR 97487-8729
(541) 908-2336
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17907
OR
Other
Enumeration date
10/19/2011
Last updated
10/19/2011
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