Individual
KILEY REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
308 SE H ST, GRANTS PASS, OR 97526-3041
(541) 660-3690
Mailing address
7461 TAKILMA RD, CAVE JUNCTION, OR 97523-9770
(541) 660-3690
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21541
OR
Other
Enumeration date
07/11/2016
Last updated
07/11/2016
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