Individual
MR. JAMES GIAMBRONE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1210 SANDPIPER LN SW, BANDON, OR 97411-8819
(541) 347-1236
Mailing address
PO BOX 1824, BANDON, OR 97411-1824
(541) 347-1236
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13723
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13723
STATE MASSAGE LICENSE
OR
Enumeration date
12/04/2008
Last updated
12/04/2008
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