Individual
MRS. MCKENZIE LEE MILLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
111 SW H ST # 8, GRANTS PASS, OR 97526-2505
(541) 441-5890
(541) 787-6009
Mailing address
1251 WALKER RD, GRANTS PASS, OR 97527-5149
(541) 441-9961
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
24552
OR
Other
Enumeration date
11/30/2018
Last updated
11/30/2018
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