Organization
INNERGIZED MOVEMENT MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL DAWN OLSON LMT (OWNER/OPERATOR)
(541) 771-2490
Entity
Organization
Contact information
Practice address
21045 BAYOU DR, BEND, OR 97702-2437
(541) 771-2490
Mailing address
1900 NE 3RD ST STE 106, MAILBOX #170, BEND, OR 97701-3889
(541) 771-2490
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
20452
OR
Other
Enumeration date
03/04/2016
Last updated
03/04/2016
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