Individual
RODDY DANIEL GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N/A
Contact information
Practice address
615 5TH ST, BROOKINGS, OR 97415-9199
(541) 813-2535
Mailing address
PO BOX 810, GOLD BEACH, OR 97444-0810
(541) 813-2535
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/06/2018
Last updated
08/06/2018
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