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Individual

DIA COUTTOUW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1375 PEARL ST, EUGENE, OR 97401-3523
(541) 683-3377
Mailing address
1375 PEARL ST, EUGENE, OR 97401-3523
(541) 683-3377

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
462071391
OR
Enumeration date
06/27/2018
Last updated
06/27/2018
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Product
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