Individual
SARA GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
203 LIBERTY ST, ASHLAND, OR 97520-2947
(541) 817-2322
Mailing address
203 LIBERTY ST, ASHLAND, OR 97520-2947
(541) 817-2322
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
21608
OR
Other
Enumeration date
04/26/2016
Last updated
04/26/2016
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