Individual
KELLY BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
501 CHENEY CREEK RD, GRANTS PASS, OR 97527
(541) 218-8204
Mailing address
501 CHENEY CREEK RD, GRANTS PASS, OR 97527-9545
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-12230
OR
Other
Enumeration date
07/19/2017
Last updated
07/19/2017
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