Individual
TERRY LYNN WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
450 MT GURNEY LN, ROSEBURG, OR 97471-8660
(541) 670-1274
Mailing address
450 MT GURNEY LN, ROSEBURG, OR 97471-8660
(541) 670-1274
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
04/04/2024
Last updated
04/04/2024
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