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Individual

MR. MARK CEDARLEAF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
705 12TH ST SE, SALEM, OR 97301-4004
(503) 375-2989
Mailing address
353 GLEN CREEK RD NW APT 16, SALEM, OR 97304-3091
(503) 375-2989

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
7983
OR

Other

Enumeration date
06/23/2010
Last updated
06/23/2010
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