Individual
TYLER HUDDLESTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1333 1ST ST, SPRINGFIELD, OR 97477-3002
(541) 736-2700
Mailing address
1333 1ST ST, SPRINGFIELD, OR 97477-3002
(541) 736-2700
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
442184
OR
Other
Enumeration date
09/27/2020
Last updated
09/27/2020
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