Individual
MR. JUSTIN ALLAN VOLKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4455 NE HIGHWAY 20, CORVALLIS, OR 97330-9695
(541) 758-5900
Mailing address
1867 21ST AVE SE APT 11, ALBANY, OR 97322-5593
(541) 829-0438
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/26/2012
Last updated
09/26/2012
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