Individual
DUSTIN A SHADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 S HOLLY STREET, MEDFORD, OR 97501-3113
(541) 774-8201
(541) 774-7979
Mailing address
140 S HOLLY STREET, MEDFORD, OR 97501-3113
(541) 774-8201
(541) 774-7979
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/02/2016
Last updated
06/02/2016
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