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Individual

MR. TED IWAMIZU

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
873 NE 7TH ST, GRANTS PASS, OR 97526-1634
(541) 474-6955
Mailing address
1440 SE ROGUE DR, GRANTS PASS, OR 97526-4065
(541) 471-2226

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4225
OR

Other

Enumeration date
05/05/2006
Last updated
07/08/2007
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