Individual
LILLIAN WISARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18 MYRTLE ST, MEDFORD, OR 97504-7338
(541) 531-1911
Mailing address
18 MYRTLE ST, MEDFORD, OR 97504-7338
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25281
OR
Other
Enumeration date
01/31/2026
Last updated
01/31/2026
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