Individual
JUSTINE CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
497 SW CENTURY DR, SUITE 120, BEND, OR 97702-1167
(541) 480-1240
Mailing address
497 SW CENTURY DR, SUITE 120, BEND, OR 97702-1167
(541) 480-1240
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20803
OR
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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