Doctor Name: | JEZELLE MARGO GEBER |
NPI Number: | 1295098937 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 18091 |
Business Practice Address: | 2728 Ne Highway 101 Suite 1 Lincoln City, OR - 973674412 |
Business Phone Number: | 5419943233 |
Business Fax Number: | |
Mailing Address: | 950 Se 32nd St, Apt 14 LINCOLN CITY |
State: | OR |
Postal Code: | 973671803 |
Phone Number: | 5038882234 |
Fax Number: | |
NPI Enumeration Date: | 06/18/2012 |
NPI Last Update Date: | 06/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 18091 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |