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General NPI Number Information
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NPI Number | 1174852602
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Entity Type | Individual
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Provider Name | CHRISTINE ALLISON RACKLEY LMT
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Gender | Female
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Dates
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Enumeration Date | 12/11/2009
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Last Update Date | 12/11/2009
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Provider Practice Location Address
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Address Line | 832 E MAIN ST
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City | MEDFORD
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State | OR
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Zip | 97504-7153
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Country | US
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Telephone | 541-772-5939
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Fax | 541-772-5939
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Provider Business Mailing Address
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Address Line | 5926 SHADY BROOK DR
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City | CENTRAL POINT
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State | OR
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Zip | 97502-9333
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Country | US
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Telephone | 541-941-4937
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Fax | 541-772-5939
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 16041
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License Number State | OR
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