Athena Wrennette Rolph, LMT

NPI #1114219110 in Boring, Oregon

Provider Information

NPI Number: 1114219110
Entity Type: Individual
Name: Athena Wrennette Rolph, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: May 9, 2011
Last Updated: May 9, 2011

Practice Location

Address: 11943 SE 362ND AVE
City: Boring
State: Oregon
ZIP Code: 97009-8720
Phone: (971) 409-0949

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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