Susan Johanna Bouman, LMT

NPI #1104303916 in Ashland, Oregon

Provider Information

NPI Number: 1104303916
Entity Type: Individual
Name: Susan Johanna Bouman, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Jul 24, 2018
Last Updated: Jul 24, 2018

Practice Location

Address: 550 SISKIYOU BLVD
City: Ashland
State: Oregon
ZIP Code: 97520-2138
Phone: (541) 488-6757

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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