Most Relevant Information
Provider Data
| NPI Number: | 1003461153 |
| Provider Name: | RILEY MITCHELL LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 24629 |
Most Important Dates
| Enumeration Date: | 08/06/2019 |
| Last Updated: | 08/06/2019 |
Provider Practice Location
223 MADRONA AVE SE
SALEM
OR
97302
Practice Location Phone/Fax
| Phone: | 5038773529 |
| Fax: |
Provider Mailing Location
223 MADRONA AVE SE
SALEM
OR
973024609
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |