Individual
CAROL MICHELLE PERSONIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.R./L
Contact information
Practice address
873 NE 7TH ST, GRANTS PASS, OR 97526-1634
(541) 479-7573
Mailing address
911 GRANITE HILL RD, GRANTS PASS, OR 97526-7895
(541) 479-7573
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
976389
OR
Other
Enumeration date
10/23/2009
Last updated
10/23/2009
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