Organization
NATURAL ESCAPE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAUN THOMAS COOPER LMT (OWNER/PROVIDER)
(541) 281-9530
Entity
Organization
Contact information
Practice address
1235 HILTON DR, KLAMATH FALLS, OR 97603-5254
(541) 281-9530
Mailing address
1235 HILTON DR, KLAMATH FALLS, OR 97603-5254
(541) 281-9530
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
5485
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5485
LMT NUMBER
OR
Enumeration date
06/02/2014
Last updated
06/02/2014
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