Individual
APRIL MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
204 N BROADWAY ST, ESTACADA, OR 97023-8542
(971) 291-4710
Mailing address
204 N BROADWAY ST, ESTACADA, OR 97023-8542
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
023572
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9367691
STATE ID
OR
Enumeration date
08/08/2018
Last updated
08/08/2018
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