Individual
JENNA E KANDRAVI GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
20995 NE LEGEND PL, BEND, OR 97701-7759
(541) 728-8013
Mailing address
2 KEEWAYDIN DR, SALEM, NH 03079-2839
(800) 995-2673
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60520
OR
Other
Enumeration date
04/11/2014
Last updated
01/20/2023
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