Individual
DARREL A DECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
350 8TH STREET, LEBANON, OR 97355
(541) 259-1221
Mailing address
924 SE BETHEL PLACE, CORVALLIS, OR 97333
(812) 585-2768
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
08867
OR
Other
Enumeration date
06/24/2015
Last updated
06/24/2015
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