Individual
DENNIS LEE MEDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
849 NE 7TH ST, GRANTS PASS, OR 97526-1634
(541) 479-0765
(541) 479-3461
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0211
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650008939
RR MEDICARE
OR
Enumeration date
11/30/2005
Last updated
11/09/2012
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