Individual
MR. THOMAS WAYNE STUTZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
168 ACKERMAN ST E, MONMOUTH, OR 97361-2214
(503) 409-5804
Mailing address
168 ACKERMAN ST E, MONMOUTH, OR 97361-2214
(503) 409-5804
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
527851
—
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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