Individual
JOANNA RENEE VONSEGGERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2625 KOOS BAY BLVD, COOS BAY, OR 97420-4907
(541) 267-2161
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9849
OR
225200000X
Physical Therapy Assistant
PTP-PTA-LIC-17197
MT
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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