Individual
HEIDI DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
960 LIBERTY ST SE STE 170, SALEM, OR 97302-4149
(503) 588-6633
Mailing address
583 IRVING DR, MYRTLE CREEK, OR 97457-7403
(541) 643-8286
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
14688
OR
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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