Individual
MR. CORY A SURATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2145 CENTENNIAL PLZ, EUGENE, OR 97401-2421
(541) 485-6340
Mailing address
1210 W 28TH AVE, EUGENE, OR 97405-2348
(617) 548-7119
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1195
MA
Other
Enumeration date
12/13/2010
Last updated
12/13/2010
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