Individual
ELIZABETH KATHLEEN FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT,CA
Contact information
Practice address
1704 ADAMS AVE, LA GRANDE, OR 97850-2914
(541) 963-4068
Mailing address
1704 ADAMS AVE, LA GRANDE, OR 97850-2914
(541) 963-4068
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8331
OR
Other
Enumeration date
09/21/2017
Last updated
07/21/2022
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