Individual
MR. BRICE TYLER STANLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
5600 HUNTINGTON RD, LAPINE COMMUNITY CLINIC, LAPINE, OR 97739
(541) 534-3435
(541) 536-8047
Mailing address
PO BOX 3300, LAPINE, OR 97739
(541) 536-3435
(541) 536-8047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA01027
OR
Other
Enumeration date
06/14/2006
Last updated
07/08/2007
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