Individual
JACKSON DUANE LAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
601 MEDICAL PKWY, ENTERPRISE, OR 97828-5124
(541) 426-3111
Mailing address
911 HAMEL DR, ENTERPRISE, OR 97828-1437
(480) 861-3804
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
221041
OR
Other
Enumeration date
04/08/2021
Last updated
11/05/2024
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