Organization
THREE CLOUDS ON MAIN WELLNESS CENTER & SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SALLY L LASSITER (OWNER/DIRECTOR)
(541) 914-2475
Entity
Organization
Contact information
Practice address
1054 E MAIN ST, COTTAGE GROVE, OR 97424-2230
(541) 942-2831
Mailing address
PO BOX 376, COTTAGE GROVE, OR 97424-0014
(541) 942-2831
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
—
—
Other
Enumeration date
06/28/2011
Last updated
06/28/2011
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