Individual
MS. CONCETTA MARIE ANTONELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
890 AVENUE F, LAKE OSWEGO, OR 97034
(503) 349-7038
Mailing address
11375 SE 33RD AVE, MILWAUKIE, OR 97222-6754
(503) 349-7038
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7449
OR
Other
Enumeration date
11/19/2007
Last updated
11/19/2007
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