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1669199469
ALEXANDER CHARLES BRODER
PORTLAND, OR
NPI
1669199469
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 17536)
Enumeration Date
2022-10-21
Last Update Date
2022-10-21
Business Address
Mr. ALEXANDER CHARLES BRODER
2149 NE BROADWAY ST
PORTLAND, OR 97232-1580
Phone number: 503-281-0278
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Mailing Address
Mr. ALEXANDER CHARLES BRODER
2149 NE BROADWAY ST
PORTLAND, OR 97232-1580
Phone number: 503-281-0278
Copy
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