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Individual

JOSIAH JACKSON DICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1460 G ST, SPRINGFIELD, OR 97477-4112
(541) 726-3166
Mailing address
PO BOX 3028, SAN DIMAS, CA 91773-7028
(541) 726-3166

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA209411
OR
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
02/01/2021
Last updated
04/21/2023
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