Provider Demographics
NPI:1497124077
Name:GARCIA, LETICIA (CERTIFIED YOGA TEACH)
Entity Type:Individual
Prefix:
First Name:LETICIA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:CERTIFIED YOGA TEACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3033 GATEWAY ST
Mailing Address - Street 2:APT 118
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-1076
Mailing Address - Country:US
Mailing Address - Phone:541-852-2799
Mailing Address - Fax:
Practice Address - Street 1:2222 COBURG RD
Practice Address - Street 2:SUITE 300
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4966
Practice Address - Country:US
Practice Address - Phone:541-852-2799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist