Individual
REBECCA DELFORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
215 MOBILE DR, ASHLAND, OR 97520-9021
(920) 737-7696
Mailing address
30 SEVENTH ST, ASHLAND, OR 97520-2132
(920) 737-7696
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201230130
OR
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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