Individual
JONATHAN ACE CEZO MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2345 BIEHN ST, KLAMATH FALLS, OR 97601-1761
(541) 882-4612
Mailing address
4507 CANNON AVE APT 27, KLAMATH FALLS, OR 97603-6769
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
60387
OR
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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