Individual
JUSTIN OLIPHANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1245 CHARNELTON ST, SUITE 6, EUGENE, OR 97401-6214
(317) 679-0273
Mailing address
611 WOODLEAF LN, EUGENE, OR 97405-4051
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21679
OR
Other
Enumeration date
04/24/2016
Last updated
04/24/2016
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