Individual
MARCIA SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 W MAIN ST, MEDFORD, OR 97501-2756
(541) 772-1777
Mailing address
1020 N BERKELEY WAY UNIT 1, MEDFORD, OR 97504-6224
(541) 816-8350
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/27/2016
Last updated
01/27/2016
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