Individual
MS. CAROLYN WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
450 NW GREENWOOD AVE, REDMOND, OR 97756-1531
(541) 923-0410
Mailing address
450 NW GREENWOOD AVE, REDMOND, OR 97756-1531
(541) 598-5114
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19040
OR
Other
Enumeration date
06/28/2012
Last updated
06/28/2012
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