Individual
KELLY SIMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
541 WILLAMETTE ST, STE #111, EUGENE, OR 97401
(541) 543-5582
Mailing address
33824 ORCHARD AVE, CRESWELL, OR 97426
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19277
OR
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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