Individual
MONTY DALE MEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSS
Contact information
Practice address
31700 FAYETTEVILLE DR, SHEDD, OR 97377-9779
(541) 491-1002
Mailing address
PO BOX 93, ALBANY, OR 97321-0028
(541) 491-1002
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OR
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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