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Individual

GERILYN JEAN AMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTRL

Contact information

Practice address
111 N 20TH ST, PHILOMATH, OR 97370-9621
(541) 368-4313
Mailing address
25989 SW NICOLE DR, CORVALLIS, OR 97333-9340
(541) 757-2754

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
340307
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
235118
OR
Enumeration date
02/17/2007
Last updated
07/08/2007
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