Individual
MR. BRUCE GLEN SCANLON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC/R
Contact information
Practice address
615 NE 15TH ST, MCMINNVILLE, OR 97128-3317
(503) 565-4357
Mailing address
615 NE 15TH ST, MCMINNVILLE, OR 97128-3317
(503) 565-4357
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-115525
OR
Other
Enumeration date
04/10/2006
Last updated
07/08/2007
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