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1972805869
ROYCE ALLEN BIVENS
MEDFORD, OR
NPI
1972805869
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: OR 16493)
Enumeration Date
2010-11-26
Last Update Date
2010-11-26
Business Address
Mr. ROYCE ALLEN BIVENS L.M.T.
2615 SPARTA WAY
MEDFORD, OR 97504-4920
Phone number: 541-778-7066
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Mailing Address
Mr. ROYCE ALLEN BIVENS L.M.T.
2615 SPARTA WAY
MEDFORD, OR 97504-4920
Phone number: 541-778-7066
Copy
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