Individual
JENNIFER FRANCES NEUDORFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
845 SW 30TH ST, CORVALLIS, OR 97331-8629
(541) 768-7700
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62723
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62723
OREGON PHYSICAL THERAPIST LICENSING BOARD
OR
Enumeration date
06/05/2018
Last updated
11/11/2020
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