Nicole Renee Mckibben, LMT

NPI #1558518779 in Dallas, Oregon

Provider Information

NPI Number: 1558518779
Entity Type: Individual
Name: Nicole Renee Mckibben, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Aug 19, 2008
Last Updated: Oct 3, 2024

Practice Location

Address: 140 SE MILL ST
City: Dallas
State: Oregon
ZIP Code: 97338-1908
Phone: (037) 878-0695

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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