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Individual

DANIEL BLAINE EGLESTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
277 W JONES CREEK RD, GRANTS PASS, OR 97526-3606
(541) 471-7245
Mailing address
277 W JONES CREEK RD, GRANTS PASS, OR 97526-3606
(541) 471-7245

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
6506
OR
225700000X
Massage Therapist
MA00012185
WA

Other

Enumeration date
04/06/2007
Last updated
07/08/2007
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