Mr. BOHANNON FARAON
Individual Provider (NPI-1)
Active
Massage Therapist
Provider Information
- NPI Number
1154274199- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 156 CHEMAWA RD N, KEIZER, OR, 973035356
- Phone
- (503) 999-5960
Specialties & Taxonomies
Massage Therapist
Primary License: OR #27265