Individual
BENJAMEN DULLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 SW CENTURY DR STE G, BEND, OR 97702-3839
(541) 504-4676
Mailing address
2616 NW BOULDER RIDGE LOOP, BEND, OR 97703-7543
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62404
OR
Other
Enumeration date
04/11/2024
Last updated
04/11/2024
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