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1275918278
SOURCE INTEGRATIVE MEDICINE LLC
PORTLAND, OR
NPI
1275918278
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Entity Type
Organization
Authorized Contact
DARA CANTOR
Owner
503-928-6728
Organization Subpart ?
No
Primary Taxonomy
171100000X Acupuncturist
(Licence: OR AC165411)
Enumeration Date
2015-07-21
Last Update Date
2015-08-06
Business Address
SOURCE INTEGRATIVE MEDICINE LLC
4424 NE GLISAN ST
PORTLAND, OR 97213-2331
Phone number: 503-928-6728
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Mailing Address
SOURCE INTEGRATIVE MEDICINE LLC
4424 NE GLISAN ST
PORTLAND, OR 97213-2331
Phone number: 503-928-6728
Copy
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