Individual
BRYAN CORLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1945 NE 205TH AVE, FAIRVIEW, OR 97024-9622
(503) 661-8050
(503) 492-4651
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
PROFESSIONALLICENSE
—
Other
Enumeration date
03/03/2016
Last updated
02/22/2023
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