Individual
PENELOPE ELIZABETH WAITS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
258 A ST STE 21, ASHLAND, OR 97520-1947
(541) 301-7040
Mailing address
258 A ST STE 1, ASHLAND, OR 97520-1947
(775) 527-5672
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25426
OR
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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