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1255887147
MITCH LONG
CORVALLIS, OR
NPI
1255887147
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 22284)
Enumeration Date
2016-08-30
Last Update Date
2016-08-30
Business Address
-- MITCH LONG LMT
320 SW 2ND ST
CORVALLIS, OR 97333-4632
Phone number: 541-602-2289
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Mailing Address
-- MITCH LONG LMT
320 SW 2ND ST
CORVALLIS, OR 97333-4632
Phone number: 541-602-2289
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