Individual
LYNDA LYNNEA FORDERER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1050 CRATER LAKE AVE, SUITE A, MEDFORD, OR 97504-6223
(541) 621-8922
(541) 773-5725
Mailing address
1050 CRATER LAKE AVE, SUITE A, MEDFORD, OR 97504-6223
(541) 621-8922
(541) 773-5725
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9232
OR
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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