Individual
CORIE WAITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
977 ROYAL AVE, MEDFORD, OR 97504-6140
(541) 779-8331
(541) 779-0217
Mailing address
3474 LONE PINE RD, MEDFORD, OR 97504-5635
(541) 301-0697
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11297
OR
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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