Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath | 17212 | OR |
Y | 225700000X | Massage Therapist | 17212 | OR |
NPI | 1689977647 |
---|---|
Provider Name | Kalinna Alderman |
First Address | Drain, OR 97435-0934 |
Second Address | Brookings, OR 97415-0241 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2010 |
Last Update Date | 02/11/2015 |