Individual
TERESA JO PANTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
625 NE GALLOWAY ST, MCMINNVILLE, OR 97128-3933
(503) 474-5012
Mailing address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
(503) 474-5012
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
111620
OR
Other
Enumeration date
09/27/2024
Last updated
09/27/2024
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