Individual
MR. KEVIN NEAL FLANIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4512 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6274
(503) 777-2776
Mailing address
7721 SE 92ND AVE APT C, PORTLAND, OR 97266-6227
(503) 734-0508
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14781
OR
Other
Enumeration date
03/24/2008
Last updated
03/24/2008
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