Individual
CASSANDRA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
598 NE E ST STE C, GRANTS PASS, OR 97526-2350
(541) 761-0017
Mailing address
1744 HAMILTON LN, GRANTS PASS, OR 97527-4702
(541) 761-0017
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27214
OR
Other
Enumeration date
08/14/2023
Last updated
08/14/2023
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