Individual
BRYAN CODINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4062 ARLETA AVE NE, KEIZER, OR 97303-4758
(503) 390-2271
(503) 390-0177
Mailing address
4062 ARLETA AVE NE, KEIZER, OR 97303-4758
(503) 390-2271
(503) 390-0177
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1066053
OR
Other
Enumeration date
07/09/2010
Last updated
07/09/2010
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