Individual
NANCY LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1289 NE 2ND ST STE 3, BEND, OR 97701-4372
(541) 317-4826
Mailing address
1289 NE 2ND ST STE 3, BEND, OR 97701-4372
(541) 317-4826
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16809
OR
Other
Enumeration date
03/25/2016
Last updated
03/25/2016
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