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Individual

DAVID BERRIS STANDIFER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICAL THERAPIST

Contact information

Practice address
1249 PLAZA BLVD, SUITE F, CENTRAL POINT, OR 97502-2670
(541) 664-2800
(541) 664-0555
Mailing address
16083 SW UPPER BOONES FERRY RD, STE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1800
OR
225100000X
Physical Therapist
PT00003465
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
014345
OR
01
650022829
RAILROAD
OR
Enumeration date
11/23/2005
Last updated
11/12/2012
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