Individual
MRS. AMY RUTH WOLTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
424 NE FRANKLIN AVE, BEND, OR 97701-4919
(541) 388-3588
Mailing address
424 NE FRANKLIN AVE, BEND, OR 97701-4919
(503) 551-2684
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21783
LICENSE
OR
Enumeration date
03/04/2019
Last updated
03/04/2019
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