Individual
JACOB GREDVIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
370 E HERSEY ST STE 1, ASHLAND, OR 97520-2325
(541) 482-6360
(541) 482-6801
Mailing address
284 W HERSEY ST UNIT 16, ASHLAND, OR 97520-1789
(952) 807-4884
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
64008
OR
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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