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Individual

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Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
540 S MAIN ST, MOUNT ANGEL, OR 97362-9540
(503) 845-6481
Mailing address
540 S MAIN ST, MOUNT ANGEL, OR 97362-9540
(503) 845-6481

Taxonomy

Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
61844
OR

Other

Enumeration date
09/24/2025
Last updated
09/24/2025
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