Individual
MRS. MELISSA CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
714 E JACKSON ST, MEDFORD, OR 97504-6712
(541) 944-5203
Mailing address
PO BOX 546, EAGLE POINT, OR 97524-0546
(541) 944-5203
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21585
OR
Other
Enumeration date
11/16/2015
Last updated
11/16/2015
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