Individual
MRS. BRENDA S DICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4705 RIVER RD N, KEIZER, OR 97303-4535
(503) 393-4121
(503) 393-3191
Mailing address
PO BOX 21689, 4705 RIVER ROAD N, KEIZER, OR 97307-1689
(503) 393-4121
(503) 393-3191
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13363
OR
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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