Georgia Fountas, LMT

NPI #1073869707 in Gresham, Oregon

Provider Information

NPI Number
1073869707
Entity Type
Individual
Name
Georgia Fountas, LMT
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Massage Therapist
Credential
LMT
Enumeration Date
Jul 31, 2012
Last Updated
Jul 31, 2012

Practice Location

Address
22400 SE STARK ST
Address 2
SUITE 104
State
Oregon
ZIP Code
97030-2656
Phone
(503) 491-5555

Specialties & Taxonomy Codes

Specialty
Massage Therapist

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