Individual
JACK DEAN BARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
82847 CLOVERDALE RD, CRESWELL, OR 97426-9477
(503) 757-6819
Mailing address
82847 CLOVERDALE RD, CRESWELL, OR 97426-9477
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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