Individual
NICHOLAS FORSBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
126 MIZE RD S, SALEM, OR 97302
(503) 999-8796
Mailing address
126 MIZE RD S, SALEM, OR 97302
(503) 999-8796
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
023122
OR
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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