Provider Demographics
NPI:1609694496
Name:KILPATRICK, JOSIE A (LMT)
Entity type:Individual
Prefix:
First Name:JOSIE
Middle Name:A
Last Name:KILPATRICK
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 VALLEY RIVER WAY STE 106
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2187
Mailing Address - Country:US
Mailing Address - Phone:541-514-4819
Mailing Address - Fax:541-897-8112
Practice Address - Street 1:1011 VALLEY RIVER WAY STE 106
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2187
Practice Address - Country:US
Practice Address - Phone:541-514-4819
Practice Address - Fax:541-897-8112
Is Sole Proprietor?:No
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR28213225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist