SOURCE INTEGRATIVE MEDICINE LLC

PORTLAND, OR
NPI1275918278
Entity TypeOrganization
Authorized ContactDARA CANTOR
Owner
503-928-6728
Organization Subpart ?No
Primary Taxonomy171100000X Acupuncturist
(Licence: OR  AC165411)
Enumeration Date2015-07-21
Last Update Date2015-08-06
Business Address
SOURCE INTEGRATIVE MEDICINE LLC
4424 NE GLISAN ST
PORTLAND, OR 97213-2331
Phone number: 503-928-6728
Mailing Address
SOURCE INTEGRATIVE MEDICINE LLC
4424 NE GLISAN ST
PORTLAND, OR 97213-2331
Phone number: 503-928-6728
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