Individual
MR. SAM JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1306 ADAMS AVE, LA GRANDE, OR 97850-2610
(541) 786-4763
Mailing address
1306 ADAMS AVE, LA GRANDE, OR 97850-2610
(541) 786-4763
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
274531
—
Other
Enumeration date
01/11/2008
Last updated
01/11/2008
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