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Individual

DR. DIANE MARIE SHAVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1600 N RIVERSIDE AVE UNIT 2027, MEDFORD, OR 97501-4665
(541) 779-9851
(541) 779-9851
Mailing address
7371 N APPLEGATE RD, GRANTS PASS, OR 97527-9443
(541) 862-2739
(541) 862-2739

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2817AT
OR

Other

Enumeration date
10/04/2010
Last updated
10/04/2010
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