Individual
RICHELLE GIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
Mailing address
863 N VIEW DR, WINCHESTER, OR 97495-7901
(541) 817-9218
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DT-DO-10226673
OR
122400000X
Denturist
DT-TMP-10210016
OR
Other
Enumeration date
10/30/2020
Last updated
05/04/2023
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