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Individual

ROBERTO EMMANUEL GUZMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3040 CENTER ST NE, SALEM, OR 97301-4528
(503) 373-3762
Mailing address
3030 CENTER ST NE, SALEM, OR 97301-4528
(503) 373-3762

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
93-6002307
OR
Enumeration date
05/17/2018
Last updated
05/17/2018
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