Individual
PAGE ELIZABETH BACKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
168 LAVENDER LN, CENTRAL POINT, OR 97502-3627
(541) 664-4677
Mailing address
168 LAVENDER LN, CENTRAL POINT, OR 97502-3627
(541) 664-4677
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
90155121870804D
OR
Other
Enumeration date
06/19/2007
Last updated
07/08/2007
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