Individual
MR. ERNEST GREAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1639 NW ESTELLE ST, ROSEBURG, OR 97471-1610
(541) 378-2488
Mailing address
1639 NW ESTELLE ST, ROSEBURG, OR 97471-1610
(541) 378-2488
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
3837189
OR
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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