Individual
JUSTINE R LUCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
222 SE URANIA LN, BEND, OR 97702-1624
(541) 647-0493
Mailing address
61183 FIR CREST KNL, BEND, OR 97702-2568
(541) 647-0493
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17408
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LMT 17408
OREGON LICENSE
OR
Enumeration date
05/07/2013
Last updated
05/07/2013
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