Individual
MS. BRANDIE COLLETTE DUPONT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, PTA, CSCS
Contact information
Practice address
685 36TH AVE NE, SALEM, OR 97301-4741
(503) 371-8860
Mailing address
3018 SW CARSON ST, PORTLAND, OR 97219-3720
(971) 275-7973
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8730
OR
Other
Enumeration date
01/26/2007
Last updated
07/06/2011
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