Individual
THERESA SELVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1200 MIRA MAR AVE, MEDFORD, OR 97504-8546
(541) 857-7130
Mailing address
8900 STERLING CREEK RD, JACKSONVILLE, OR 97530-8933
(541) 857-7130
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
523
OR
Other
Enumeration date
11/14/2013
Last updated
11/14/2013
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