Individual
AMY ULTCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
155 W A ST, SPRINGFIELD, OR 97477-4516
(541) 747-4555
Mailing address
155 W A ST, SPRINGFIELD, OR 97477-4516
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21267
CA
Other
Enumeration date
01/04/2016
Last updated
01/07/2016
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