Individual
KIMO CECIL COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
727 SE CASS AVE STE 308, ROSEBURG, OR 97470-4954
(541) 530-3016
Mailing address
130 HARVEST LN, ROSEBURG, OR 97471-9269
(541) 530-3016
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28013
OR
Other
Enumeration date
11/22/2021
Last updated
11/18/2024
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