Individual
QUCHYAL LEI DANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
141 SW G ST, GRANTS PASS, OR 97526-2413
(541) 479-8621
(541) 479-8621
Mailing address
680 ROBMAR LN, GRANTS PASS, OR 97527-8936
(541) 226-7605
(541) 479-8621
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3584
OR
Other
Enumeration date
03/24/2007
Last updated
07/08/2007
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