Individual
CLANCY SANDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
18 MYRTLE ST # 7025, MEDFORD, OR 97504-7338
(541) 531-1911
Mailing address
224 CHERYL LN APT 5, PHOENIX, OR 97535-8701
(541) 778-5929
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27851
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27851
OREGON BOARD OF MASSAGE
OR
Enumeration date
08/10/2023
Last updated
08/10/2023
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