Individual
MRS. KIMBERLY DAWN MERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4356 COMMERCIAL ST SE, SALEM, OR 97302-3914
(503) 689-1216
Mailing address
1197 SW LINDEN LN, DALLAS, OR 97338-9042
(971) 239-3229
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25425
OR
Other
Enumeration date
09/25/2020
Last updated
09/25/2020
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