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Individual

BROOK ADALE WITTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
606 MEDICAL PKWY, ENTERPRISE, OR 97828-5140
(541) 426-4524
Mailing address
62264 SKI RUN RD, JOSEPH, OR 97846-8209
(541) 620-0849

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
OR

Other

Enumeration date
12/16/2024
Last updated
12/16/2024
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