Organization
BOB BELLONI RANCH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER LANGLIE (EXECUTIVE DIRECTOR)
(541) 269-0321
Entity
Organization
Contact information
Practice address
320 CENTRAL AVE STE 406, COOS BAY, OR 97420-2241
(541) 269-0321
Mailing address
320 CENTRAL AVE STE 406, COOS BAY, OR 97420-2241
(541) 269-0321
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500400418
—
OR
Enumeration date
09/26/2013
Last updated
09/26/2013
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