Individual
ETHAN H CANOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
333 SW 5TH ST STE B, GRANTS PASS, OR 97526-2509
(541) 471-0397
(541) 471-6459
Mailing address
333 SW 5TH ST STE B, GRANTS PASS, OR 97526-2509
(541) 471-0397
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26776
OR
225700000X
Massage Therapist
—
—
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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