MRS. Constance Jo Ervin, LMT

NPI #1780006361 in Dallas, Oregon

Provider Information

NPI Number: 1780006361
Entity Type: Individual
Name: MRS. Constance Jo Ervin, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Jan 15, 2014
Last Updated: Jan 15, 2014

Practice Location

Address: 289 E ELLENDALE AVE
Address 2: SUITE 102
City: Dallas
State: Oregon
ZIP Code: 97338-1580
Phone: (503) 623-5505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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