Individual
RICKY VANRHEENEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 PARK AVE, BROOKINGS, OR 97415-9145
(541) 469-3111
Mailing address
1 PARK AVE, BROOKINGS, OR 97415-9145
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8816
OR
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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