Individual
MARY BETH WAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 EXECUTIVE PKWY STE 220, EUGENE, OR 97401-7109
(541) 345-1669
(541) 359-2238
Mailing address
1400 EXECUTIVE PKWY STE 220, EUGENE, OR 97401-7109
(541) 345-1669
(541) 359-2238
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25074
OR
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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