Individual
DAISY TABALDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1007 W CENTRAL AVE, SUTHERLIN, OR 97479-9471
(541) 643-0569
Mailing address
1007 W CENTRAL AVE, SUTHERLIN, OR 97479-9471
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
13289
OR
Other
Enumeration date
08/12/2010
Last updated
08/12/2010
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