Individual
MR. CLINT RODREICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
149 S MAIN ST, PHOENIX, OR 97535-6631
(531) 535-4133
Mailing address
149 S MAIN ST, PHOENIX, OR 97535-6631
(531) 535-4133
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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