Individual
JULIA DENEA BREIDENBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
312 CHURCH ST, GASTON, OR 97119-7844
(503) 625-0100
Mailing address
312 CHURCH ST, GASTON, OR 97119-7844
(503) 625-0100
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16500
OR
Other
Enumeration date
08/30/2011
Last updated
08/30/2011
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