Individual
CHARLES L FITZSIMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 MULLINS DR, SUITE A-1, LEBANON, OR 97355-3982
(541) 451-6920
(541) 451-6924
Mailing address
100 MULLINS DR, SUITE A-1, LEBANON, OR 97355-3982
(541) 451-6920
(541) 451-6924
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/30/2012
Last updated
05/30/2012
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