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Individual

DANIEL BRASCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
702 SW RAMSEY AVE, SUITE 220, GRANTS PASS, OR 97527-5858
(541) 479-0765
(541) 479-3461
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6590
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500639148
OR
01
P01021707
RR MEDICARE
OR
Enumeration date
09/21/2011
Last updated
11/01/2012
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