Individual
DUSTIN TALBOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6395 KEIZER STATION BLVD NE STE 103, KEIZER, OR 97303-2305
(503) 589-1597
Mailing address
722 S GRICE LOOP, JEFFERSON, OR 97352-8903
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
01/06/2020
Last updated
01/06/2020
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