Individual
MR. JOHN ERIC FORDYCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2045 SILVERTON RD NE STE A, SALEM, OR 97301-0100
(593) 588-5358
(503) 361-2688
Mailing address
4140 MUNKERS ST SE, SALEM, OR 97317-5841
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
THW000107123
OR
Other
Enumeration date
11/23/2022
Last updated
11/23/2022
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