Organization
GRAPE STREET MASSAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA K SHORKEY (OWNER, LICENSED MASSAGE THERAPIST)
(541) 261-8628
Entity
Organization
Contact information
Practice address
312 S GRAPE ST, MEDFORD, OR 97501-3147
(541) 261-8628
(938) 888-7262
Mailing address
782 COLUMBINE WAY, CENTRAL POINT, OR 97502-4802
(541) 261-8625
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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