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Individual

MR. JAMES ROBERT KORNBAU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S.

Contact information

Practice address
160 S 2ND ST, COOS BAY, OR 97420-1603
(541) 266-9639
(541) 266-9763
Mailing address
56515 LEVI BUNCH RD, COQUILLE, OR 97423-7742
(541) 396-3467
(541) 266-9763

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
21488
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
126354
OR
Enumeration date
04/26/2007
Last updated
07/08/2007
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