Individual
MR. PHILIP LEE HARDISON, JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
913 NW GARDEN VALLEY BLVD, ROSEBURG, OR 97470-6523
(541) 440-1000
(541) 677-3189
Mailing address
190 CHEROKEE AVE, ROSEBURG, OR 97470-9523
(541) 673-0260
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
OR
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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