Individual
JEANNIE DURYEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 PARK AVE, BROOKINGS, OR 97415-9145
(541) 469-3111
Mailing address
925 WEAVER LN, BROOKINGS, OR 97415-8271
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
7538
OR
Other
Enumeration date
02/13/2013
Last updated
02/13/2013
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