Individual
OMAR VITELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
687 S FRONT ST, WOODBURN, OR 97071-5511
(503) 406-0292
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/03/2023
Last updated
05/03/2023
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