Individual
KEITH R. WOLFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
913 NW GARDEN VALLEY BLVD, BLDG 1, RM C100, ROSEBURG, OR 97470-6523
(541) 440-1000
Mailing address
PO BOX 1574, ROSEBURG, OR 97470-0364
(541) 440-1000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
992378
OR
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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