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Individual

MR. TRISTAN PROETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSPT

Contact information

Practice address
913 11TH ST SE, SUITE 1, BANDON, OR 97411-9168
(541) 347-4314
(541) 347-8006
Mailing address
913 11TH ST SE, SUITE 1, BANDON, OR 97411-9168
(541) 347-4314
(541) 347-8006

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3745
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
269048
OR
Enumeration date
08/25/2006
Last updated
07/08/2007
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