Provider Demographics
NPI:1750744538
Name:PILLAR MASSAGE AND EXERCISE THERAPY
Entity type:Organization
Organization Name:PILLAR MASSAGE AND EXERCISE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASSAGE THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BRUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:541-337-9547
Mailing Address - Street 1:366 E 40TH AVE STE 285
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3424
Mailing Address - Country:US
Mailing Address - Phone:541-337-9547
Mailing Address - Fax:
Practice Address - Street 1:366 E 40TH AVE STE 285
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3424
Practice Address - Country:US
Practice Address - Phone:541-337-9547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6886172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty