Individual
MRS. MIA N DEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1150 CRATER LAKE AVE, STE. G, MEDFORD, OR 97504-6213
(541) 857-4540
Mailing address
2408 BELL CT, MEDFORD, OR 97504-1752
(541) 261-6170
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13269
OR
Other
Enumeration date
07/14/2007
Last updated
07/14/2007
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