Individual
BRYAN WILLIAM LEASURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 ROSE AVE, MEDFORD, OR 97501-2556
(541) 301-8982
Mailing address
643 5TH AVE, GOLD HILL, OR 97525-9756
(541) 778-5278
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/13/2019
Last updated
09/13/2019
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