Individual
GRAEME JESSEN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
226 NW F ST, GRANTS PASS, OR 97526-2050
(541) 659-8032
Mailing address
226 NW F ST, GRANTS PASS, OR 97526-2050
(541) 659-8032
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21958
OR
Other
Enumeration date
02/08/2016
Last updated
02/08/2016
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