Individual
TIMOTHY HAROLD HEDSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
415 GLENDA AVE, ROSEBURG, OR 97470-1020
(541) 680-7063
Mailing address
415 GLENDA AVE, ROSEBURG, OR 97470-1020
(541) 680-7063
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
229461090
OR
343900000X
Non-emergency Medical Transport (VAN)
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Other
Enumeration date
07/07/2025
Last updated
07/07/2025
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