Individual
JERYL M COSSETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
76370 ROCK RD, OAKRIDGE, OR 97463-9541
(541) 782-4416
Mailing address
76372 ROCK RD, OAKRIDGE, OR 97463-9541
(541) 782-4416
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
6936
OR
Other
Enumeration date
06/19/2007
Last updated
07/08/2007
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