Individual
CAROLINE SUSAN PACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2260 CRICKET CT. S, SALEW, OR 97302-3657
(707) 999-8793
Mailing address
2260 CRICKET CT. S, SALEM, OR 97302-3657
(707) 999-8793
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/06/2017
Last updated
09/06/2017
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