Individual
KELLEY WHARITY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
825 MONROE ST STE 4, EUGENE, OR 97402-5176
(541) 632-3359
Mailing address
1373 GOODPASTURE ISLAND RD, EUGENE, OR 97401-1788
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24244
OR
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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