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1780006361
CONSTANCE JO ERVIN
DALLAS, OR
NPI
1780006361
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 17273)
Enumeration Date
2014-01-15
Last Update Date
2014-01-15
Business Address
Mrs. CONSTANCE JO ERVIN LMT
289 E ELLENDALE AVE SUITE 102
DALLAS, OR 97338-1580
Phone number: 503-623-5505
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Mailing Address
Mrs. CONSTANCE JO ERVIN LMT
289 E ELLENDALE AVE SUITE 102
DALLAS, OR 97338-1580
Phone number: 503-623-5505
Copy
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