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Individual

MRS. OLIVIA M KAPPEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMT, CST, NUT

Contact information

Practice address
628 N 1ST ST, STE C, LAKEVIEW, OR 97630-1506
(541) 947-5011
(541) 947-5013
Mailing address
628 N 1ST ST, STE C, LAKEVIEW, OR 97630-1506
(541) 947-5011
(541) 947-5013

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
1667
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1667
STATE LICENSE NUMBER
OR
Enumeration date
03/29/2007
Last updated
07/08/2007
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