Individual
DIANA LOUISE DURHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
65675 GERKING MARKET RD, BEND, OR 97703-5255
(541) 788-0787
Mailing address
65675 GERKING MARKET RD, BEND, OR 97703-5255
(541) 788-0787
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8164
OR
Other
Enumeration date
05/18/2011
Last updated
07/08/2020
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