Therapeutic Laser Center

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

THERAPEUTIC LASER CENTER

Practice address

115 W Stewart Ave
Medford, OR 97501-3607

Phone

(541) 772-7007

Fax

(541) 772-7771

NPI assigned

Jul 12, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mary Anne Crandall, PHD, CLT

Title

Doctor of Natural Science,

Phone

(541) 772-7007

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821096033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W STEWART AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013607",
            "telephone_number": "541-772-7007",
            "fax_number": "541-772-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W STEWART AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975013607",
            "telephone_number": "541-772-7007",
            "fax_number": "541-772-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC LASER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CRANDALL",
        "authorized_official_first_name": "MARY ANNE",
        "authorized_official_title_or_position": "DOCTOR OF NATURAL SCIENCE,",
        "authorized_official_telephone_number": "541-772-7007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, CLT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Visage of Beauty LLC
• James William Theen, MD
• Laurie L. Theodorou, LCSW
• Therapeutic Associates Inc
• Therapeutic Associates Inc
• Marissa Marie Thibert
• David Keith Thielges, DC
• Third Coast Anesthesia
• Adria Felice Thomas, AGNP-C
• Dani J Thomas, DO

• Rehabilitation Clinic/Center in Medford, OR
• Providers in Medford, OR by specialty
• Rehabilitation Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.