| NPI | 1396029914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDIN THIBODEAUX Owner/Operator 503-550-5083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225700000X Massage Therapist (Licence: OR 11652) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2011-09-30 |