Individual
EVAN AMELUXEN-COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1590 NE 3RD ST STE B, PRINEVILLE, OR 97754-2916
(541) 416-7476
Mailing address
805 SW INDUSTRIAL WAY STE 3, BEND, OR 97702-1093
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62505
OR
Other
Enumeration date
09/12/2017
Last updated
09/15/2017
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