Individual
EMILY WHITESIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
900 SUNSET DR, LA GRANDE, OR 97850-1387
(541) 963-1529
Mailing address
900 SUNSET DR, LA GRANDE, OR 97850-1387
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63003
OR
Other
Enumeration date
04/02/2019
Last updated
04/02/2019
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