Individual
JOHN HUDSPETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
560 NW 27TH ST, CORVALLIS, OR 97330-5223
(541) 766-6835
Mailing address
560 NW 27TH ST, CORVALLIS, OR 97330-5223
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PI-0011183
OR
Other
Enumeration date
04/18/2014
Last updated
04/18/2014
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