Individual
MR. GREG GLENN GILL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25915 S FALLSVIEW RD, BEAVERCREEK, OR 97004-9638
(503) 550-0321
Mailing address
PO BOX 323, BEAVERCREEK, OR 97004-0323
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/15/2010
Last updated
07/15/2010
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