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Individual

DAVID J. CONVIRS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
348 RUBY AVE, EUGENE, OR 97404-2033
(541) 461-3075
Mailing address
715 SW RAMSEY AVE, GRANTS PASS, OR 97527-5500
(541) 956-4943
(541) 956-5463

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019047
OR
Enumeration date
08/29/2011
Last updated
08/03/2016
About Stedi
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