Individual
JACK DILLON BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC-R
Contact information
Practice address
300 W MAIN ST, MEDFORD, OR 97501-2756
(541) 772-1777
(541) 734-2410
Mailing address
971 PEACHWOOD CT, MEDFORD, OR 97501-8108
(541) 772-1777
(541) 734-2410
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/18/2025
Last updated
08/18/2025
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