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Individual

JOHN O WOLCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
927 NE FAILING ST, PORTLAND, OR 97212-1228
(971) 219-1835
Mailing address
927 NE FAILING ST, PORTLAND, OR 97212-1228
(971) 219-1835

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18365
OR

Other

Enumeration date
01/23/2012
Last updated
04/16/2015
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