Individual
DONALD KIRK WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
158 MAIN, EAGLE POINT, OR 97524
(541) 830-0914
Mailing address
PO BOX 1409, EAGLE POINT, OR 97524-1409
(541) 830-0914
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1003
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
211144
—
OR
Enumeration date
01/16/2007
Last updated
04/10/2008
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