Individual
MARK GOTCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
315 S PACIFIC HWY 99, COTTAGE GROVE, OR 97424-2137
(541) 942-0176
(541) 942-0177
Mailing address
PO BOX 626, COTTAGE GROVE, OR 97424-0027
(541) 942-0176
(541) 942-0177
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2529AT
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208414
—
OR
Enumeration date
11/15/2005
Last updated
10/29/2007
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