Individual
MR. JEFFREY ALAN HARDISTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ACSM CPT
Contact information
Practice address
2420 CANTERBURY ST, EUGENE, OR 97404-1901
(541) 729-2920
Mailing address
2420 CANTERBURY ST, EUGENE, OR 97404-1901
(541) 729-2920
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
690411
OR
Other
Enumeration date
01/24/2013
Last updated
01/24/2013
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