Individual
REBEKAH MARLENE CONNELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LD
Contact information
Practice address
65 N HIGHWAY 101, WARRENTON, OR 97146-9371
(503) 861-8624
(503) 861-8625
Mailing address
65 N HIGHWAY 101, WARRENTON, OR 97146-9371
(503) 861-8624
(503) 861-8625
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DT-TMP-10248215
OR
Other
Enumeration date
10/08/2024
Last updated
10/08/2024
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