Individual
MR. KEITH OSCAR MANICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICENSED MASSAGE THE
Contact information
Practice address
2596 E BARNETT RD, ROGUE HEALTH LLC, MEDFORD, OR 97504-4340
(541) 261-2222
Mailing address
630 E 9TH ST, MEDFORD, OR 97504-7321
(541) 261-2222
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12489OREGON
OR
Other
Enumeration date
05/09/2007
Last updated
06/27/2016
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