Individual
MS. STACY L THETFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
230 E MAIN ST, ROGUE RIVER, OR 97537-9416
(541) 582-2323
(541) 582-2419
Mailing address
PO BOX 1467, ROGUE RIVER, OR 97537-1467
(541) 582-2323
(541) 582-2419
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OR3171
OR
Other
Enumeration date
10/11/2005
Last updated
09/06/2013
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