Carol Tewalt

NPI #1528467131 in Sisters, Oregon

Provider Information

NPI Number: 1528467131
Entity Type: Individual
Name: Carol Tewalt
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Aug 19, 2014
Last Updated: Aug 19, 2014

Practice Location

Address: 16410 HIGHWAY 126
City: Sisters
State: Oregon
ZIP Code: 97759-9599
Phone: (971) 302-5479

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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