Individual
KIRK ROLAND STONICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
422 N MAIN ST, CONDON, OR 97823-7651
(541) 384-2061
Mailing address
422 N MAIN ST, CONDON, OR 97823-7651
(541) 384-2061
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA213416
OR
Other
Enumeration date
05/23/2020
Last updated
10/05/2022
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