Individual
JULIAN CANGILOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
1328 NW 6TH STREET, GRANTS PASS, OR 97526-1255
(541) 660-5559
Mailing address
P.O. BOX 664, GRANTS PASS, OR 97528-0057
(541) 660-5559
(541) 474-6310
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
15467
OR
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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