Individual
MICHAEL GENE BLACKMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1675 WILLAMETTE ST, EUGENE, OR 97401
(541) 915-5263
(541) 607-2671
Mailing address
1675 WILLAMETTE ST, EUGENE, OR 97401
(541) 915-5263
(541) 607-2671
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6637
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6637
LMT
OR
Enumeration date
04/25/2006
Last updated
12/04/2008
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