Individual
EMMA FASHBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18 MYRTLE ST, MEDFORD, OR 97504-7338
(541) 531-1911
(541) 816-4939
Mailing address
18 MYRTLE ST, MEDFORD, OR 97504-7338
(541) 531-1911
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25945
OR
Other
Enumeration date
12/14/2020
Last updated
12/14/2020
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