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Individual

SAMUEL STEWART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1777 COBURG RD STE 3, EUGENE, OR 97401-5477
(541) 505-8041
(541) 505-9956
Mailing address
1200 CORPORATE DR STE 400, BIRMINGHAM, AL 35242-5424
(423) 682-8840
(423) 602-2028

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
61671
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0355691
WA L&I
OR
01
0355692
WA L&I
OR
01
0355693
WA L&I
OR
05
500708180
OR
Enumeration date
05/18/2016
Last updated
05/03/2019
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