Individual
AMANDA WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
819 E MAIN ST, COTTAGE GROVE, OR 97424-2045
(541) 778-6882
Mailing address
819 E MAIN ST, COTTAGE GROVE, OR 97424-2045
(541) 778-6882
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25392
OR
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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