Individual
DANIELLE LAURIE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
1980 LANDERS AVE, ROSEBURG, OR 97471-4705
(541) 852-7143
Mailing address
1729 IRELAND RD, WINSTON, OR 97496-4570
(541) 852-7143
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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