Individual
DAN RICHARD IBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
2395 NW STEWART PKWY, ROSEBURG, OR 97470-5653
(541) 957-5825
(541) 957-5801
Mailing address
2395 NW STEWART PKWY, ROSEBURG, OR 97470-5653
(541) 957-5825
(541) 957-5801
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3599
OR
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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