NPI 1033401385

Penne Sue Ellen Phifer, LMT

Practitioner Mechanotherapist Madras, OR

Practice location

Address: 212 SW 4th St Suite 202, Madras, OR 97741-1322
Phone: (541) 480-1643

Registered specialties

Mechanotherapist Primary

Other Service Providers Taxonomy 172M00000X Licence 16496 (OR)

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Registry record

NPI: 1033401385
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 May 2011
Record last updated: 4 May 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.