Individual
JAY M DICHARRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1160 SW SIMPSON AVE, SUITE 200, BEND, OR 97702-3542
(541) 322-9045
(541) 322-9044
Mailing address
805 SW INDUSTRIAL WAY, SUITE 3, BEND, OR 97702-1093
(541) 585-2529
(541) 585-2536
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6798
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500646505
—
OR
Enumeration date
04/26/2012
Last updated
03/03/2016
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