Individual
MICHAEL SERVANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
308 N LAUREL ST, ASHLAND, OR 97520-1111
(541) 482-9182
(541) 482-9181
Mailing address
308 N LAUREL ST, ASHLAND, OR 97520-1111
(541) 482-9182
(541) 482-9181
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3323
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J918101
PACIFIC SOURCE
OR
Enumeration date
03/15/2007
Last updated
07/08/2007
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