Individual
STACY MOSBRUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3580 NW SAMARITAN DR, CORVALLIS, OR 97330-3766
(541) 768-5157
Mailing address
3580 NW SAMARITAN DR, CORVALLIS, OR 97330-3766
(541) 768-5157
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8467
OR
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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