Individual
KELLEY MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
240 PHELPS ST, SILVERTON, OR 97381-1927
(503) 873-1647
Mailing address
PO BOX 3290, PORTLAND, OR 97208-3290
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
04034
OR
Other
Enumeration date
10/25/2007
Last updated
10/25/2007
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