Individual
MR. JEFFERY W RETKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
770 SE KANE ST, ROSEBURG, OR 97470-3943
(541) 464-6455
Mailing address
1023 NE BARAGER AVE, ROSEBURG, OR 97470-5620
15414648775
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/09/2017
Last updated
06/09/2017
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