Individual
MS. MELINDA LEE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T
Contact information
Practice address
272 W 11TH AVE, EUGENE, OR 97401-3031
(541) 357-0314
Mailing address
1250 ELLSWORTH ST, EUGENE, OR 97402-1519
(541) 357-0314
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10375
OR
Other
Enumeration date
11/30/2012
Last updated
11/30/2012
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